Reproductive Health Care in Catholic-Owned Hospitals

Hill, Elaine; Slusky, David; Ginther, Donna K.

doi:10.3386/w23768

Cited by 3 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Second, this paper adds to the literature on how provider ownership interacts with price incentives and regulation in healthcare Duggan (2000); Grabowski and Hirth (2003); Grabowski et al (2013); Clemens and Gottlieb (2014); Adelino et al (2015); Hill et al (2019); Curto et al (2019). 4 Some work points to non-pecuniary objectives of nonprofits as one reason nonprofit providers can outperform for-profits.…”

Section: Introductionmentioning

confidence: 99%

Does Private Equity Investment in Healthcare Benefit Patients? Evidence from Nursing Homes

et al. 2021

View full text Add to dashboard Cite

The past two decades have seen a rapid increase in Private Equity (PE) investment in healthcare, a sector in which intensive government subsidy and market frictions could lead high-powered for-profit incentives to be misaligned with the social goal of affordable, quality care. This paper studies the effects of PE ownership on patient welfare at nursing homes.With administrative patient-level data, we use a within-facility differences-in-differences design to address non-random targeting of facilities. We use an instrumental variables strategy to control for the selection of patients into nursing homes. Our estimates show that PE ownership increases the short-term mortality of Medicare patients by 10%, implying 20,150 lives lost due to PE ownership over our twelve-year sample period. This is accompanied by declines in other measures of patient well-being, such as lower mobility, while taxpayer spending per patient episode increases by 11%. We observe operational changes that help to explain these effects, including declines in nursing staff and compliance with standards. Finally, we document a systematic shift in operating costs post-acquisition toward non-patient care items such as monitoring fees, interest, and lease payments.

show abstract

Section: Introductionmentioning

confidence: 99%

Does Private Equity Investment in Healthcare Benefit Patients? Evidence from Nursing Homes

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The association between unbundling and IPP LARC provision also likely differs by hospital-level factors, and quantifying that variation is critical to guide prioritization of technical assistance, education, and outreach resources to ensure equitable access to IPP LARC. Hospital-level factorsdincluding academic affiliation and Catholic statusdare highly associated with IPP LARC access, but have been understudied in the context of unbundling (Hill et al, 2017). Catholic health care institutions restrict contraceptive care provision among other reproductive services, which may impose a hard limit to the promise of Medicaid unbundling, especially in states with high saturation of Catholic facilities (Uttley & Khaikin, 2016).…”

mentioning

confidence: 99%

Provision of Immediate Postpartum Long-Acting Reversible Contraceptives Before and After Wisconsin Medicaid's Payment Change

Kramer

Gangnon

Burns

2021

Women's Health Issues

View full text Add to dashboard Cite

Objectives: We aimed to estimate the association between Medicaid unbundling of payment for long-acting reversible contraceptives (LARC) from the global delivery fee and immediate postpartum (IPP) LARC provision, in a state outside a select group of early-adopters. We also examine the potential moderating roles of hospital academic affiliation and Catholic status on the association between unbundling and IPP LARC provision. Methods: We used a pre-post design to examine the association between unbundling and IPP LARC provision. We observed Medicaid-covered childbirth deliveries in Wisconsin hospitals between January 2016 and December 2017 (n ¼ 45,200) in the State Inpatient Database from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project. We conducted multivariate regressions using generalized linear mixed models. Results: From 2016 to 2017, IPP LARC provision increased from 0.28% to 0.44% of deliveries (p ¼ .003). In our adjusted model, IPP LARC provision was 1.55 times more likely in the post-period versus the pre-period (95% confidence interval, 1.12-2.13). Both before and after unbundling, IPP LARC provision was significantly more common in academic versus nonacademic settings and was exceedingly rare in Catholic institutions. Conclusions: In contrast with many early adopting states, in this later adopting state, Wisconsin Medicaid's unbundling of LARC from the global fee did not meaningfully change the rates of IPP LARC provision. These results indicate that delivery hospital characteristics are strong correlates of access to IPP LARC and suggest the need for interventionsdperhaps outside of the inpatient settingdto ensure that patients can access desired contraceptive methods promptly postpartum.

show abstract

“…Because the ERDs prohibit sterilization, patients delivering their children at faith-based hospitals are unable to request this additional postpartum procedure (Menegay et al 2022;Stulberg et al 2014). Indeed, mergers resulting in hospitals' switch to Catholic ownership were found to reduce rates of tubal ligation by 30% (Hill, Slusky, and Ginther 2019). This restriction particularly disadvantages women who have a family history of ovarian cancer, for whom opportunistic salpingectomies are the recommended cancer prevention strategy by the American College of Obstetricians and Gynecologists (Committee on Gynecologic Practice 2019) and the Society of Gynecologic Oncology (Society of Gynecologic Oncology 2013).…”

Section: Family Planningmentioning

confidence: 99%

“…Faith-based hospitals, like those owned or affiliated with the Catholic Church or Seventh-Day Adventist Church, operate on religious doctrine that can prevent women, sexual minorities, and gender minorities from receiving evidence-based and doctor-informed care Hill, Slusky, and Ginther 2019;Kaye et al 2016;Stulberg et al 2010Stulberg et al , 2012Stulberg et al , 2014. Catholic 2 hospital systems impose the most severe faith-based restrictions on SRH because they operate under the Ethical and Religious Directives (ERDs) written by the U.S. Conference of Catholic Bishops (United States Conference of Catholic Bishops 2018).…”

Section: Introductionmentioning

confidence: 99%

The Growing Presence of Faith-Based Hospitals in California Restricts Access to Sexual and Reproductive Healthcare

Hebner¹,

Lim²,

Gehred³

et al. 2023

CJPP

View full text Add to dashboard Cite

Sexual and reproductive healthcare restrictions imposed by faith-based hospitals prevent women, sexual minorities, and gender minorities from accessing the full range of comprehensive healthcare. The share of faith-based hospitals in California has increased rapidly in recent years, but no analysis has been completed to understand their distribution and rate of growth. In this paper, we calculate the percentage of religiously affiliated acute, short-term hospital beds per California county. We find that faith-based hospitals have a majority market share in 17 out of 58 California counties. Furthermore, while the percentage of faith-based hospitals in these counties has remained relatively stable from 2000-2010, this proportion has increased tenfold in the past decade. Our data suggest that the expansion of faith-based healthcare systems in California presents a significant barrier to sexual and reproductive healthcare access.

show abstract

Reproductive Health Care in Catholic-Owned Hospitals

Cited by 3 publications

References 21 publications

Does Private Equity Investment in Healthcare Benefit Patients? Evidence from Nursing Homes

Does Private Equity Investment in Healthcare Benefit Patients? Evidence from Nursing Homes

Provision of Immediate Postpartum Long-Acting Reversible Contraceptives Before and After Wisconsin Medicaid's Payment Change

The Growing Presence of Faith-Based Hospitals in California Restricts Access to Sexual and Reproductive Healthcare

Contact Info

Product

Resources

About