| By: |
de Elejalde, Ramiro (Banco Central de Chile);
Giolito, Eugenio (Universidad del CEMA) |
| Abstract: |
We study the causal effect of delivering in a private rather than a public
hospital on maternal outcomes in Chile. We exploit a 2003 copayment reduction
that expanded access to private hospitals for women insured by the public
system as an instrument for private delivery. Combining administrative birth
records with hospital discharge data, we estimate an instrumented
difference-in-differences model that follows mothers for up to fifteen years
after the first birth. Private hospital delivery improves short-term outcomes,
reducing prolonged hospitalizations and 30-day readmissions. The offsetting
risks come with later pregnancies: women induced to deliver in private
hospitals face higher rates of repeat C-sections, cesarean-scar complications,
and hysterectomy. Subsequent fertility is unaffected. The results point to a
trade-off between short-run improvements and long-run maternal health risks
from hospital practices that favor planned cesarean delivery. |
| Keywords: |
cesarean section, maternal health, private hospitals, provider incentives |
| JEL: |
I11 I12 I13 I18 J13 |
| Date: |
2026–08 |
| URL: |
https://d.repec.org/n?u=RePEc:iza:izadps:dp18877 |