Working Paper: NBER ID: w28256
Authors: Michael D. Frakes; Jonathan Gruber; Timothy Justicz
Abstract: Recent debates over health care reform, including in the context of the Military Health System (MHS) and Veterans Health Administration, highlight the dispute between public and private provision of health care services. Using novel data on childbirth claims from the MHS and drawing on the combination of plausibly exogenous patient moves and heterogeneity across bases in the availability of base hospitals, we identify the impact of receiving obstetrical care on versus off military bases. We find evidence that off-base care is associated with slightly greater resource intensity, but also notably better outcomes, suggesting marginal efficiency gains from care privatization.
Keywords: Military Health System; Public vs. Private Care; Health Outcomes; Resource Utilization
JEL Codes: H1; H51; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| care location (off-base vs. on-base) (I19) | resource utilization (Q21) |
| care location (off-base vs. on-base) (I19) | maternal and neonatal outcomes (J13) |
| mothers moving closer to base hospitals (J45) | birth outcomes (J13) |
| mothers moving further from base hospitals (I19) | birth outcomes (J13) |