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The Impact of a Raise in Reimbursement: A Payment Increase for Vaginal Delivery in 2005 as an Example
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Journal Article
The Impact of a Raise in Reimbursement: A Payment Increase for Vaginal Delivery in 2005 as an Example
2019
Overview
In May 2005, Bureau of National Health Insurance doubled the reimbursement for vaginal delivery to the same rate as paid for cesarean section (c-section) in order to reduce the c-section rate and improve the quality of care. This reimbursement adjustment provides an excellent opportunity to examine whether such a payment increase can improve healthcare quality. Using obstetric cases of firstborns in 2004 and 2006 from National Health Insurance Data, this study examines if there was a negative relation between quality indicators (e.g. c-section, re-admission, and length of stay) and doctor's income, measured in terms of payments paid by NHI for baby delivery. To control for the endogenous bias, the study employs \"first-difference\" methods to attenuate the bias arising from unobserved factors, and restricts the sample to firstborn babies. Our results indicate that the doctor's income and c-section rate is statistically uncorrelated on the whole, but negatively related for doctors who previously had a lower perc
Publisher
Taiwan Economic Review
Subject
