The Cesarean Decision in New York State, 1986

Do expert patients get better treatment than others? Agency discrimination and statistical discrimination in obstetrics

“…In a similar study, Gruber et al found a positive and significant relationship between fees for Caesarean section and the number of Caesarean sections that were carried out (Gruber et al, 1999). Several other studies from the 1980s and the 1990s also found that the rate of Caesarean section was influenced by how doctors were remunerated or how hospitals were funded (Tussing and Wojtowycz, 1992;Stafford, 1990;Ransom et al, 1996).…”

“…One issue that has been raised is whether obstetricians take their own private economic interests into account when deciding on type of delivery (for example see: Gruber and Owings, 1996;Tussing and Wojtowycz, 1992;Keeler and Brodie, 1993;Grant, 2009). Most of the studies are from the United States, Brazil, Chile, Taiwan and Korea (Henderson et al, 2001).…”

Explaining Source of Payment Differences in U.S. Cesarean Rates: Why do Privately Insured Mothers Receive More Cesareans than Mothers Who are not Privately Insured?

“…Previous work has identified a positive association between cesarean rates and maternal education [47], income [17], and Hispanic ethnicity [19]. Some of these variables, such as education, are positively associated with private insurance, while others, such as Hispanic ethnicity, are negatively associated.…”

“…Two studies[3,47] find smaller differentials. Both contain more controls than is typical in this literature, but neither tests to see if these smaller effects obtain because of the additional controls, as opposed to, say, the region being studied.…”

Financial incentives do not always work—An example of cesarean sections in Taiwan

“…Of these, a pregnant woman having previously had a cesarean section is by far the most influential [22]. Brown also showed that among five risk factors considered -fetal distress, use of epidural anesthesia, dystocia, age of mother, and a repeat cesarean section -the mother's age and a repeat cesarean section were significant factors in determining whether or not to perform a cesarean section delivery [16].…”