Does higher Institutional Quality improve the Appropriateness of Healthcare Provision?

• 成果类型: Article
• 署名作者: De Luca, Giacomo; Lisi, Domenico; Martorana, Marco; Siciliani, Luigi
• 署名单位: University of York - UK; University of Catania; Free University of Bozen-Bolzano
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2020.104356
• 发表日期: 2021
• 关键词: Institutional quality; Appropriateness; Healthcare provision; iv; Cesarean sections

摘要

We study the effect of institutional quality on the appropriateness of healthcare provision in Italian hospitals. We focus on cesarean section rates for first-time mothers, which is a common indicator of appropriateness in healthcare and is vulnerable to providers' opportunistic behaviors. To identify the causal effect of institutional quality we rely on an IV strategy based on historical instruments, exploiting the idea that current differences in institutional quality across regions have been shaped by different cultural and political histories. We find that a standard deviation increase in our indicator of institutional quality leads to a decrease of about 10 percentage points in cesarean section rates. Our results are robust to different measures of institutional quality and samples. (C) 2020 Published by Elsevier B.V.