Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the U.S.

Fischer, Stefanie; Royer, Heather; White, Corey

doi:10.1257/app.20220341

Abstract

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.

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Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the U.S.

Abstract

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