Working Paper: NBER ID: w23768
Authors: Elaine L. Hill; David Slusky; Donna Ginther
Abstract: Mergers that affiliate a hospital with a Catholic owner, network, or system reduce the set of possible reproductive medical procedures since Catholic hospitals have strict prohibitions on contraception. Using changes in ownership of hospitals, we find that Catholic hospitals reduce the per bed rates of tubal ligations by 31%, whereas there is no significant change in related permitted procedures such as Caesarian sections. However, across a variety of measures, we find minimal overall welfare reductions. Still, fewer tubal ligations increase the risk of unintended pregnancies across the United States, imposing a potentially substantial cost for less reliable contraception on women and their partners.
Keywords: Reproductive health; Catholic hospitals; Health care access; Hospital mergers
JEL Codes: J13; L31; Z12
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Changes in hospital ownership to catholic affiliation (Z12) | Reduction in the rate of tubal ligations (J19) |
| Changes in hospital ownership to catholic affiliation (Z12) | Declines in vasectomies and abortions (J13) |
| Changes in hospital ownership to catholic affiliation (Z12) | No changes in cesarean sections (J19) |
| Changes in hospital ownership to catholic affiliation (Z12) | No evidence of increased risks associated with catholic hospitals (Z12) |
| Reduction in the rate of tubal ligations (J19) | Increased unintended pregnancies (J13) |
| Changes in hospital ownership to catholic affiliation (Z12) | No significant changes in severe maternal morbidity (I10) |