The Rise in C-sections: From Incentives to Consequences
Speaker: Maripier Isabelle, University of Toronto
Maripier Isabelle is a PhD candidate in economics at the University of Toronto. She holds a M.A. in economics from l’Université Laval and is currently a Junior fellow at Massey College and a Fellow of the Canadian Center for Health Economics. Her research focuses on topics in health economics, including physician responses to financial incentives and the determinant of child health.
Caesarean section rates have risen steadily across the OECD in the past two decades. In the United States and in Canada, they have reached levels nearly twice as high as the benchmark suggested by the World Health Organization, suggesting that an important proportion of births delivered by caesarean may not be medically necessary. This talk will address two questions raised by this trend: How can we explain the level of current C-section rates and what are the long term consequences of this phenomenon for children? Exploiting the unique features of the Canadian health care system and using data on the population of Canadian births between 1994 and 2010, we will first investigate the impact of the financial incentives on physicians’ choice of birth delivery methods in a fee-for-service environment. Informed by the results from this study, we will then explore the causal relationship between C-section birth and health outcomes later in childhood using an instrumental variable framework and data from fourteen cohorts of Canadian children. Preliminary results suggest that the consequences of performing unnecessary C-sections extend beyond the higher resource cost associated with the birth delivery procedure itself.
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