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The establishment of interventions to maximize maternal health requires the identification of modifiable risk factors. Toward the identification of modifiable hospital-based factors, we analyze over 2 million births from 2005 to 2010 in Texas, employing a series of quasiexperimental tests involving hourly, daily, and monthly circumstances where medical service quality (or clinical capital) is known to vary exogenously. Motivated by a clinician's choice model, we investigate whether maternal delivery complications (1) vary by work shift, (2) increase by the hours worked within shifts, (3) increase on weekends and holidays when hospitals are typically understaffed, and (4) are higher in July when a new cohort of residents enter teaching hospitals. We find consistent evidence of a sizable statistical relationship between deliveries during nonstandard schedules and negative patient outcomes. Delivery complications are higher during night shifts (OR = 1.21, 95% CI: 1.18-1.25), and on weekends (OR = 1.09, 95% CI: 1.04-1.14) and holidays (OR = 1.29, 95% CI: 1.04-1.60), when hospitals are understaffed and less experienced doctors are more likely to work. Within shifts, we show deterioration of occupational performance per additional hour worked (OR = 1.02, 95% CI: 1.01-1.02). We observe substantial additional risk at teaching hospitals in July (OR = 1.28, 95% CI: 1.14-1.43), reflecting a cohort-turnover effect. All results are robust to the exclusion of noninduced births and intuitively falsified with analyses of chromosomal disorders. Results from our multiple-test strategy indicate that hospitals can meaningfully attenuate harm to maternal health through strategic scheduling of staff.

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We use a unique data set containing information from state individual income tax returns, Wisconsin unemployment insurance wage data, and data collected by hand from Wisconsin courthouses to examine the earned income tax credit (EITC) usage by divorced men and women with children. We show that a large percentage of divorced adults with children file tax returns. Moreover, many receive the EITC benefit through the tax system, which results in substantial additional resources for the household. We find little evidence of divorced parents engaging in strategic allocations of their children to maximize EITC claims. We also find that many EITC-eligible low-income parents fail to claim it. A potentially cost-effective way to increase the resources available to low-income working families is to provide easy-to-understand information on child-related provisions in the tax code at the time the court order is established. Downloaded from The earned income tax credit (EITC) is designed to enhance the value of work for low-income individuals, particularly those with children. Taxpayers gain access to the EITC by having earnings and incomes below certain thresholds and by filing a tax return that reports an EITCqualifying child. 1 A child must live with the taxpayer more than half the year to be EITC-qualifying (this is also known as the residency test).Tax returns do not collect information on the location of children during the year. Consequently, without additional information, it is impossible to know whether households eligible for the EITC are failing to get the credit. Child placement data linked to tax return information can be useful for learning more about two aspects of EITC claiming patterns. First, the child placement data used in this article identify the custodial parent and the noncustodial parent. The custodial parent generally has physical placement of the child. If true, then EITC claims made by someone other than the custodial parent could be potentially noncompliant. Hence, by linking child placement and tax data, we have the opportunity to assess whether a household that appears eligible for the credit fails to receive it, and whether households that are receiving the credit perhaps should not be. Second, many individuals with children have low or moderate income after divorce. Children in these households may be particularly vulnerable. Hence, given our interest in factors affecting economic well-being, it is useful to learn more about the level and composition of resources available to families.The rules determining who can legally claim an EITC-qualifying child are complex, particularly in cases where the biological parents are not living together. It is likely, therefore, that typical taxpayers do not fully understand these rules. For example, the rules defining a dependent versus EITCqualifying child for tax purposes differ. A taxpayer claiming a dependent exemption must meet, among other things, the support test, which requires the taxpayer to provide at least half the support for the child in ques...