The Impact of Financial Incentives on Cesarean Rates: Evidence from a Large Subsidy Program in Iran

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Taheri, Sarina | 2020

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Type of Document: M.Sc. Thesis
Language: Farsi
Document No: 52773 (44)
University: Sharif University of Technology
Department: Management and Economics
Advisor(s): Rahmati, Mohammad Hossein
Abstract:
On May 5, 2014, Iran began the Health Transformation Plan in public hospitals to promote vaginal delivery by increasing physician fees and by freeing payment of natural labor. About five month later part of the plan extended to non-public hospitals, and the fee of vaginal delivery increased there as well. These consequent exogenous policies provide an ideal environment to examine how Ob/Gyn physicians and pregnant mothers respond to financial incentives using difference-in-difference identification. We find that after the first reform caesarean rates declined by 4.92 percent in public hospitals without any health deterioration, a significant but modest drop. Our results suggest that in the first reform, financial incentives for patients are on the same scale as incentives for physicians. Labors for averaged weight babies, diabetic and young pregnant mothers declined more broadly than the rest. The results suggest a significant "induced monetary demand" for Ob/Gyn physicians but economically small
Keywords:
Giving Birth ; Physician Induced Demand ; Physician Monetary Incentives ; Cesarean Rate ; Promote Vaginal Delivery

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