Studying quasi‐experimental data from French hospitals from 2010 to 2013, we test the effects of a substantial diagnosis‐related group (DRG) tariff refinement that occurred in 2012, designed to reduce financial risks of French maternity wards. To estimate the resulting DRG incentives with regard to the choice between scheduled C‐sections and other modes of child delivery, we predict, based on pre‐admission patient characteristics, the probability of each possible child delivery outcome and calculate expected differences in associated tariffs. Using patient‐level administrative data, we find that introducing additional severity levels and clinical factors into the reimbursement algorithm had no significant effect on the probability of a scheduled C‐section being performed. The results are robust to multiple formulations of DRG financial incentives. Our paper is the first study that focuses on the consequences of a DRG refinement in obstetrics and develops a probabilistic approach suitable for measuring the expected effects of DRG fee incentives in the presence of multiple tariff groups.

This study evaluates the impact of introducing the Maternity Capital (MC) program—a child subsidy of 250,000 Rub (7,150 euros or 10,000 USD, in 2007)—provided to mothers giving birth to/adopting a second or subsequent child since January 2007. Eligible Russian families could use this subsidy to improve family housing conditions, fund child’s education/childcare, or invest in the mother’s retirement fund. This study evaluates the impact of MC eligibility on various child health and developmental outcomes, household consumption patterns, and housing quality. Using data from the representative Russian Longitudinal Monitoring Survey 2010–2017, I tested regression discontinuity models and found that MC eligibility may have led to a small improvement in child health status, which could be explained by improved housing conditions, particularly in rural areas. However, children living in MC-eligible families were also more likely to report reduced socialisation. Heterogeneity analysis by child gender, household poverty status, and urban/rural residence suggests that MC incentives may have had a differential impact on some analysed outcomes. Results are robust to different polynomial and nonparametric RDD specifications.