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<p>In this paper we assess the extent to which patient and physician preferences determine birth timing manipulation in public and private hospitals, among white and black mothers, using data from approximately 37&#xa0;million births in Brazil. Our findings show that manipulation is markedly salient in the private sector and among white women. While the timing of births in the public sector is also influenced by specific incentives, their impact is less pronounced and more evenly distributed across racial groups. The analysis provides a comprehensive and integrated assessment of how treatment decisions respond to different individual incentives, for different population groups, and within distinct institutional settings, thus allowing for comparison of magnitude of estimates across health systems and populations.</p>

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Patient and medical choice across public and private health providers: the case of birth timing manipulation in Brazil

  • 期刊论文

  • 发表日期：

    2025年12月29日

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  • Paula Spinola,
  • Rudi Rocha

摘要

In this paper we assess the extent to which patient and physician preferences determine birth timing manipulation in public and private hospitals, among white and black mothers, using data from approximately 37 million births in Brazil. Our findings show that manipulation is markedly salient in the private sector and among white women. While the timing of births in the public sector is also influenced by specific incentives, their impact is less pronounced and more evenly distributed across racial groups. The analysis provides a comprehensive and integrated assessment of how treatment decisions respond to different individual incentives, for different population groups, and within distinct institutional settings, thus allowing for comparison of magnitude of estimates across health systems and populations.