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  5. Does Healthcare Consolidation Harm Patients? Evidence from Maternity Ward Closures

Does Healthcare Consolidation Harm Patients? Evidence from Maternity Ward Closures

  • Daniel Avdic
  • Petter Lundborg
  • Johan Vikström
American Economic Journal: Economic Policy (Forthcoming)

Abstract

Recent healthcare consolidation trends across the world raise important questions about the tradeoff between efficiency gains and the quality and accessibility of health care. In this paper, we study how closures of maternity wards affect maternal and neonatal health, choices of birth technology, and distance to wards. We find that the closures increased the risk of maternal trauma and prolonged labor, but also decreased fetal stress and infant trauma among newborns. Adverse maternal outcomes are partly driven by ward overcrowding, whereas increases in travel distance have no distinguishable effects. Positive effects on infant health reflect a shift of births from smaller to larger wards of higher quality. Our results highlight the complex effects of healthcare consolidation and are directly relevant to ongoing policy debates on the merits of maternity ward consolidation.

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