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  • 2021
  • Working Paper
  • 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
  • Format:Print
  • | Language:English
  • | Pages:70
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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.)
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About The Author

Jorge Tamayo

Strategy
→More Publications

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More from the Authors
  • The Health Costs of Dirty Energy: Evidence from the Capacity Market in Colombia By: Achyuta Adhvaryu, Theresa Molina, Anant Nyshadham, Jorge Tamayo and Nicholas Torres
  • Reskilling in the Age of AI By: Jorge Tamayo, Leila Doumi, Sagar Goel, Orsolya Kovács-Ondrejkovic and Raffaella Sadun
  • Formal Employment and Organized Crime: Regression Discontinuity Evidence from Colombia By: Gaurav Khanna, Carlos Medina, Anant Nyshadham, Jorge Tamayo and Nicolas Torres
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