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

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  • Grytten, Jostein
  • Skau, Irene
  • Sørensen, Rune
Abstract
We address models that can explain why expert patients (obstetricians, midwives and doctors) are treated better than non-experts (mainly non-medical training). Models of statistical discrimination show that benevolent doctors treat expert patients better, since experts are better at communicating with the doctor. Agency theory suggests that doctors have an incentive to limit hospital costs by distorting information to non-expert patients, but not to expert patients. The hypotheses were tested on a large set of data, which contained information about the highest education of the parents, and detailed medical information about all births in Norway during the period 1967-2005 (Medical Birth Registry). The empirical analyses show that expert parents have a higher rate of Caesarean section than non-expert parents. The educational disparities were considerable 40 years ago, but have become markedly less over time. The analyses provide support for statistical discrimination theory, though agency theory cannot be totally excluded.

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  • Grytten, Jostein & Skau, Irene & Sørensen, Rune, 2011. "Do expert patients get better treatment than others? Agency discrimination and statistical discrimination in obstetrics," Journal of Health Economics, Elsevier, vol. 30(1), pages 163-180, January.
    • Handle: RePEc:eee:jhecon:v:30:y:2011:i:1:p:163-180
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    1. Henry, O.A. & Gregory, K.D. & Hobel, C.J. & Platt, L.D., 1995. "Using ICD-9 codes to identify indications for primary and repeat cesarean sections: Agreement with clinical records," American Journal of Public Health, American Public Health Association, vol. 85(8), pages 1143-1146.
    2. Leone, Tiziana & Padmadas, Sabu S. & Matthews, Zoë, 2008. "Community factors affecting rising caesarean section rates in developing countries: An analysis of six countries," Social Science & Medicine, Elsevier, vol. 67(8), pages 1236-1246, October.
    3. Epstein, Andrew J. & Nicholson, Sean, 2009. "The formation and evolution of physician treatment styles: An application to cesarean sections," Journal of Health Economics, Elsevier, vol. 28(6), pages 1126-1140, December.
    4. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-1296, December.
    5. Jonathan Gruber & Maria Owings, 1996. "Physician Financial Incentives and Cesarean Section Delivery," RAND Journal of Economics, The RAND Corporation, vol. 27(1), pages 99-123, Spring.
    6. Balsa, Ana I. & McGuire, Thomas G., 2003. "Prejudice, clinical uncertainty and stereotyping as sources of health disparities," Journal of Health Economics, Elsevier, vol. 22(1), pages 89-116, January.
    7. Grant, Darren, 2009. "Physician financial incentives and cesarean delivery: New conclusions from the healthcare cost and utilization project," Journal of Health Economics, Elsevier, vol. 28(1), pages 244-250, January.
    8. Stafford, R.S., 1990. "Cesarean section use and source of payment: An analysis of California hospital discharge abstracts," American Journal of Public Health, American Public Health Association, vol. 80(3), pages 313-315.
    9. Lin, Herng-Ching & Xirasagar, Sudha & Kao, Senyeong, 2004. "Association of hospital ownership with patient transfers to outpatient care under a prospective payment system in Taiwan," Health Policy, Elsevier, vol. 69(1), pages 11-19, July.
    10. Brown, Iii, H. Shelton, 2007. "Lawsuit activity, defensive medicine, and small area variation: the case of cesarean sections revisited," Health Economics, Policy and Law, Cambridge University Press, vol. 2(3), pages 285-296, July.
    11. Balsa, Ana I. & McGuire, Thomas G., 2001. "Statistical discrimination in health care," Journal of Health Economics, Elsevier, vol. 20(6), pages 881-907, November.
    12. Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
    13. Arima, Yuzo & Guthrie, Brandon L. & Rhew, Isaac C. & De Roos, Anneclaire J., 2009. "The impact of the First Steps prenatal care program on birth outcomes among women receiving Medicaid in Washington State," Health Policy, Elsevier, vol. 92(1), pages 49-54, September.
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    3. Zamora, Paula & Mantilla, César & Blanco, Mariana, 2021. "Price discrimination in informal labor markets in Bogotá: an audit experiment during the 2018 FIFA World Cup," Journal for Labour Market Research, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany], vol. 55, pages 1-6.
    4. Amy Finkelstein & Petra Persson & Maria Polyakova & Jesse M. Shapiro, 2022. "A Taste of Their Own Medicine: Guideline Adherence and Access to Expertise," American Economic Review: Insights, American Economic Association, vol. 4(4), pages 507-526, December.
    5. Fiva, Jon H. & Hægeland, Torbjørn & Rønning, Marte & Syse, Astri, 2014. "Access to treatment and educational inequalities in cancer survival," Journal of Health Economics, Elsevier, vol. 36(C), pages 98-111.
    6. David Card & Alessandra Fenizia & David Silver, 2023. "The Health Impacts of Hospital Delivery Practices," American Economic Journal: Economic Policy, American Economic Association, vol. 15(2), pages 42-81, May.
    7. Jostein Grytten & Lars Monkerud & Irene Skau & Anne Eskild & Rune J. Sørensen & Ola Didrik Saugstad, 2017. "Saving Newborn Babies – The Benefits of Interventions in Neonatal Care in Norway over More Than 40 Years," Health Economics, John Wiley & Sons, Ltd., vol. 26(3), pages 352-370, March.
    8. Erin M. Johnson & M. Marit Rehavi, 2016. "Physicians Treating Physicians: Information and Incentives in Childbirth," American Economic Journal: Economic Policy, American Economic Association, vol. 8(1), pages 115-141, February.
    9. Gabriel A. Facchini Palma, 2020. "Low Staffing in the Maternity Ward: Keep Calm and Call the Surgeon," Working Papers wpdea2009, Department of Applied Economics at Universitat Autonoma of Barcelona.
    10. Jostein Grytten & Irene Skau & Rune Sørensen, 2013. "Do Mothers Decide? The Impact of Preferences in Healthcare," Journal of Human Resources, University of Wisconsin Press, vol. 48(1), pages 142-168.
    11. Greve, Jane & Kristensen, Søren Rud & Lydiksen, Nis, 2023. "Patient and peer: Guideline design and expert response," Journal of Health Economics, Elsevier, vol. 92(C).
    12. David Card & Alessandra Fenizia & David Silver, 2018. "The Health Effects of Cesarean Delivery for Low-Risk First Births," NBER Working Papers 24493, National Bureau of Economic Research, Inc.
    13. Aleksandr Proshin & Alexandre Cazenave-Lacroutz & Zeynep Or & Lise Rochaix, 2018. "Impact of Diagnosis Related Group Refinement on the Choice Between Scheduled Caesarean Section and Normal Delivery: Recent Evidence from France," Working Papers halshs-01812107, HAL.
    14. Elisabeth Artmann & Hessel Oosterbeek & Bas van der Klaauw, 2022. "Do Doctors Improve the Health Care of Their Parents? Evidence from Admission Lotteries," American Economic Journal: Applied Economics, American Economic Association, vol. 14(3), pages 164-184, July.
    15. Grytten, Jostein & Skau, Irene & Sørensen, Rune, 2017. "The impact of the mass media on obstetricians’ behavior in Norway," Health Policy, Elsevier, vol. 121(9), pages 986-993.
    16. Jakobsson, Niklas & Kotsadam, Andreas & Syse, Astri & Øien, Henning, 2016. "Gender bias in public long-term care? A survey experiment among care managers," Journal of Economic Behavior & Organization, Elsevier, vol. 131(PB), pages 126-138.

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