医院分娩的长期影响

Martin Fischer, M. Karlsson, Nikolaos Prodromidis
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摘要

本文分析了制度交付对死亡率和社会经济结果的长期影响。我们利用瑞典在1926 - 1946年期间影响医院分娩费用和产科病房供应的两项干预措施。利用产科病房供应的外生变化来衡量机构分娩的可能性,我们发现在医院分娩对教育和死亡率等后期生活结果有实质性影响。我们认为,由于更好地治疗并发症,儿童发病率的下降是一个可能的机制。小学表现的证据证实了这一解释,表明表现不佳的可能性大大降低。由于供应增加,医院分娩立即大量增加,与此相反,我们发现取消收费并没有增加医院分娩,而是在一定程度上取代了高经济地位的父母。
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Long‐term Effects of Hospital DeliveriesThe
This paper analyzes the long‐term effects on mortality and socio‐economic outcomes from institutional delivery. We exploit two Swedish interventions that affected the costs of hospital deliveries and the supply of maternity wards during the 1926–46 period. Using exogenous variation in the supply of maternity wards to instrument the likelihood of institutional delivery, we find that delivery in hospital has substantial effects on later‐life outcomes such as education and mortality. We argue that a decrease in child morbidity due to better treatment of complications is a likely mechanism. This interpretation is corroborated by evidence from primary school performance, showing a large reduction in the probability of low performance. In contrast to an immediate and large take‐up in hospital deliveries as response to an increase in the supply, we find no increase in hospital births from the abolishment of fees – but some degree of displacement of high‐SES parents.
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