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首页> 外文期刊>Journal of health economics >Low-risk isn't no-risk: Perinatal treatments and the health of low-income newborns
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Low-risk isn't no-risk: Perinatal treatments and the health of low-income newborns

机译：低风险并非没有风险：围产期治疗和低收入新生儿的健康

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We investigate the effects of perinatal medical treatments on low-income newborns who are classified as low-risk. A policy rule in The Netherlands states that low-risk deliveries before week 37 should be supervised by physicians and later deliveries only by midwives with no physician present. This creates large discontinuities in the probability of receiving medical interventions only physicians are allowed to perform. Using a regression discontinuity design, we find that babies born slightly before the week-37 cutoff are significantly less likely to die than babies born slightly later. Our data suggest that physician supervision of birth reduces the likelihood of adverse events such as fetal distress or emergency C-section. Our results indicate that low-income women benefit from receiving a higher level of medical care even if no explicit risk factors have been recognized, pointing to challenges in identifying all high-risk pregnancies. "Back-of-the-envelope" calculations suggest this additional care is highly cost-effective. (C) 2019 Elsevier B.V. All rights reserved.
机译：我们调查围产期药物治疗对被归类为低风险的低收入新生儿的影响。荷兰的一项政策规定规定，在第37周之前进行低风险分娩应由医生进行监督，以后仅由没有医生在场的助产士进行分娩。这在仅允许医生进行医疗干预的可能性上造成很大的不连续性。使用回归不连续性设计，我们发现，在第37周截止之前出生的婴儿比在稍晚出生的婴儿死亡的可能性要小得多。我们的数据表明，医生对出生的监督减少了发生不良事件（如胎儿窘迫或紧急剖腹产）的可能性。我们的结果表明，即使没有明确的危险因素，低收入妇女也将从接受更高水平的医疗服务中受益，这对确定所有高风险怀孕提出了挑战。 “封底”计算表明，这种额外的护理具有很高的成本效益。 （C）2019 Elsevier B.V.保留所有权利。

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