Publications
Publications
- 2021
- HBS Working Paper Series
The Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes
By: Arlen Guarin, Christian Posso, Estefania Saravia and Jorge Tamayo
Abstract
Identifying the effect of physicians’ skills on health outcomes is a challenging task due to the nonrandom sorting between physicians and hospitals. We overcome this challenge by exploiting a Colombian government program that randomly assigned 2,126 physicians to 618 small hospitals. We estimate the impact on the 256,806 children whose mothers received care in those hospitals during their pregnancy, using administrative data from the program, vital statistics records, and individual records from mandatory health-specific college graduation exams. We find that more-skilled physicians improve health at birth outcomes. A one standard deviation increase in the health graduation exam scores of physicians decreases the probability of giving birth to an unhealthy baby by 6.31 percent. Finally, we present evidence that one potential underlying mechanism includes improving the targeting of care toward the more vulnerable mothers.
Keywords
Physicians' Health Skills; Health Birth Outcomes; Birthing Outcomes; Experimental Evidence; Health Care and Treatment; Competency and Skills; Outcome or Result; Health Industry; Colombia
Citation
Guarin, Arlen, Christian Posso, Estefania Saravia, and Jorge Tamayo. "The Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes." Harvard Business School Working Paper, No. 22-015, February 2021. (Revised November 2021.)