By the same authors

From the same journal

From the same journal

Do Public Hospitals Respond to Changes in DRG Price Regulation? The Case of Birth Deliveries in the Italian NHS

Research output: Contribution to journalArticlepeer-review

Full text download(s)

Published copy (DOI)



Publication details

JournalHealth Economics
DateAccepted/In press - 15 May 2017
DatePublished (current) - 21 Sep 2017
Number of pages15
Pages (from-to)23-37
Original languageEnglish


We study how changes in Diagnosis-Related Group price regulation affect hospital behaviour in quasi-markets with exclusive provision by public hospitals. Exploiting a quasi-natural experiment, we use a difference-in-differences approach to test whether public hospitals respond to an exogenous change in Diagnosis-Related Group tariffs by increasing C-section rates and/or by upcoding. Controlling for a detailed set of mother characteristics, we find that price changes did not affect the probability of a C-section. We do however find evidence of upcoding: Conditional on the birth delivery method (either a C-section or a vaginal delivery), public hospitals experiencing the largest price change exhibit a higher probability of treating patients coded as complicated. This finding suggests that even public hospitals may be sensitive to market incentives.

Bibliographical note

© 2017 John Wiley & Sons, Ltd. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.

    Research areas

  • DRG price regulation, birth deliveries, inappropriateness, public hospitals, upcoding

Discover related content

Find related publications, people, projects, datasets and more using interactive charts.

View graph of relations