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CINCH - Health Economics Research Center

Virtual Essen Health Economics Seminar


On Monday, April 12 2021, 16:00 - 17:30, Esmée Zwiers (Princeton) will present:

Pill vs Gatekeeper Power: Birth Control Access, Religious Beliefs, and Women’s Outcomes

We study how access to birth control affects short- and long-term outcomes of women in a new context: the 1970 liberalization of the contraceptive pill in the Netherlands. We first document a massive immediate drop in the birth rate post-liberalization that was particularly strong for young women, the group for which access restrictions were most drastically lifted. We then exploit area level social norms – proxied by votes for religious parties who were against relaxing access rules – to obtain causal estimates of the impact of the availability of the pill on female fertility control and especially changes in the prevalence of ill-timed births. We find that women who lived in areas that were less religiously resistant to the introduction of the pill were much less likely to experience an underage birth or marriage. These women went on to invest more in education and ended up in wealthier households. We then measure the importance of birth control providers’ beliefs in providing access to the available technology by estimating the additional effect of the religiosity of local health professionals on women’s outcomes. We that find a larger proportion of religious ‘gatekeepers’ around a woman at the time of liberalization all but wiped out any positive pill impact.

Room: Due to the current situation regarding the COVID-19 pandemic, the talk will be held in a virtual seminar room. For more information click here.

New CINCH Working Paper


A new working paper has been added to the CINCH working paper series: “Providers, Peers and Patients: How do Physicians’ Practice Environments Affect Patient Outcomes?” by Daniel Avdic, Maryna Ivets, Bo Lagerqvist, and Ieva Sriubaite.

Abstract: We study the extent to which physician treatment styles are determined by their practice environment and whether such decisions affect the quality of care received by patients. Using rich data on all coronary angioplasty procedures in Sweden 2004–2013, our empirical approach compares stent choices of interventional cardiologists moving across hospitals to patient outcomes over time. To disentangle changes in practice styles attributable to physical (provider) and social (peer group) factors, we exploit quasi‐random variation on physicians working on the same day in the same hospital. Our findings suggest that (i) moving cardiologists’ stent choices rapidly adapt to their new practice environment after relocation; (ii) practice style changes are equally driven by the physical and social environments; and (iii) rates of decision errors, treatment costs and adverse clinical events among treated patients remain largely unchanged despite the altered practice styles.

See all working papers.

Virtual Essen Health Economics Seminar


On Monday, February 8 2021, 16:00 - 17:30, Frank Schilbach (MIT) will present:

The Economic Consequences of Increasing Sleep Among the Urban Poor

Using state-of-the-art technology, we document that adults in Chennai sleep only 5.5 hours per night on average despite spending 8 hours in bed. Their sleep is highly interrupted, with sleep efficiency—sleep per time in bed—comparable to those with disorders such as sleep apnea or insomnia. A randomized three-week treatment providing information, encouragement, and improvements to home sleep environments increased sleep duration by 27 minutes per night but came at the cost of more time in bed. Contrary to expert predictions, increased night sleep had no detectable effects on cognition, productivity, decision-making or well-being, and led to small decreases in labor supply. Yet, increased sleep can have benefits in this setting: short afternoon naps at the workplace improved an overall index of outcomes by 0.12 standard deviations, with significant increases in productivity, psychologica lwell-being, and cognitive function, but less time available for work.

Room: Due to the current situation regarding the COVID-19 pandemic, the talk will be held in a virtual seminar room. For more information click here.