Does Experience Rating Improve Obstetric Practices? Evidence from Italy
Language English Country Great Britain, England Media print-electronic
Document type Journal Article
PubMed
26095679
DOI
10.1002/hec.3210
Knihovny.cz E-resources
- Keywords
- C-sections JEL K13, I13, K32, experience rating, medical liability insurance, scheduled damages,
- MeSH
- Cesarean Section statistics & numerical data MeSH
- Adult MeSH
- Models, Econometric MeSH
- Practice Patterns, Physicians' economics statistics & numerical data MeSH
- Humans MeSH
- Insurance, Liability economics statistics & numerical data MeSH
- Obstetrics economics standards statistics & numerical data MeSH
- Pregnancy MeSH
- Pregnancy Outcome economics epidemiology MeSH
- Malpractice economics statistics & numerical data MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Italy epidemiology MeSH
Using inpatient discharge records from the Italian region of Piedmont, we estimate the impact of an increase in malpractice pressure brought about by experience-rated liability insurance on obstetric practices. Our identification strategy exploits the exogenous location of public hospitals in court districts with and without schedules for noneconomic damages. We perform difference-in-differences analysis on the entire sample and on a subsample which only considers the nearest hospitals in the neighborhood of court district boundaries. We find that the increase in medical malpractice pressure is associated with a decrease in the probability of performing a C-section from 2.3 to 3.7 percentage points (7-11.6%) with no consequences for medical complications or neonatal outcomes. The impact can be explained by a reduction in the discretion of obstetric decision-making rather than by patient cream skimming.
Copenhagen Business School Baffi Center CEIS and CIFREL
University of Economics Prague CERGE EI Prague Czech Republic
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