Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the U.S.
American Economic Journal: Applied Economics (Forthcoming)
Over the last few decades, health care services in the United States have become more geographically
centralized. We study how the loss of hospital-based obstetric units in over 400
counties affect maternal and infant health via a difference-in-differences design. We find that
closures lead mothers to experience a significant change in birth procedures such as inductions
and C-sections. In contrast to concerns voiced in the public discourse, the effects on a range of
maternal and infant health outcomes are negligible or slightly beneficial. While women travel
farther to receive care, closures induce women to receive higher quality care.