【主讲】胡恬燕 (Florida International University)
【主题】The Benefits of Prenatal Care: Evidence from the SARS Epidemic in Taiwan
【时间】2015年12月23日 (周三) 15：30-17：00
【地点】上海财经大学经济学院楼602室
【语言】英文
【摘要】The positive association between prenatal care and birth outcomes has been established by numerous studies. However, there is scarce literature identifying the causal effect of prenatal care on birth outcomes. On the one hand, women anticipating a poor birth outcome may be more likely to have prenatal care, which could lead to an underestimation of the effect of prenatal care. On the other hand, women with a propensity to engage in a variety of healthy behaviors may also be more likely to have prenatal care, which could lead to an overestimation of the effect of prenatal care. In this paper, we use the variation in prenatal care visits within a given social group generated by the 2003 SARS epidemic in Taiwan to examine the impact of prenatal care on birth outcomes. (During the SARS epidemic period, people are less likely to have prenatal care visits.) The birth outcomes studied in this paper include preterm delivery, low birth weight (LBW), very low birth weight (VLBW), infant died within 1 month after delivery, infant died within three months after delivery, and any preventable complication during delivery. Because pregnant women were exposed to the SARS epidemic at different points during their pregnancy, we can isolate the impact of missing prenatal visits early or late in a pregnancy. Our paper has four main data sources, which are Taiwan’s national health insurance data, hospital basic files, annual birth certificates, and annual death certificates. From these data, we derive information on patient characteristics (such as age, gender, race) as well as medical information (such as diagnoses, procedure, DRG codes, and charge). The longitudinal nature of medical claims data also allows us to further control for the mother fixed effects. Our first stage results show that the contagion effects are strong during SARS epidemic, and the decline in prenatal care visits is larger among women in rural areas. Our instrumental variable results show that prenatal care visits play important roles in lowering the probability of having birth complication, incidences of low birth weight, and very low birth weight.
