Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the United States

• 成果类型: Article
• 署名作者: Fischer, Stefanie; Royer, Heather; White, Corey
• 署名单位: Monash University; University of California System; University of California Santa Barbara; National Bureau of Economic Research
• 刊物名称: AMERICAN ECONOMIC JOURNAL-APPLIED ECONOMICS
• ISSN/ISSBN: 1945-7782
• DOI: 10.1257/app.20220341
• 发表日期: 2024
• 页码: 113-141
• 关键词: geographic-variation; family physicians; hospital closures; prenatal-care; access; outcomes; mortality; services

摘要

Over the last few decades , health care services in the United States have become more geographically centralized. We study how the loss of hospital -based obstetric units in over 400 counties affects maternal and infant health via a difference -in -differences design. We find that closures lead mothers to experience a significant change in birth procedures such as inductions and C -sections. In contrast to concerns voiced in the public discourse , the effects on a range of maternal and infant health outcomes are negligible or slightly beneficial. While women travel farther to receive care , closures induce women to receive higher quality care.