We examine whether same-sex marriage legalization announcements impact the occurrence of LGBT hate-crimes. We exploit variation in the timing of same-sex marriage legalization announcements across states, using a difference-in-differences design. We find that a same-sex marriage legalization announcement leads to a reduction in the LGBT hate-crime rate of 0.111 per 100,000 people from a base of 0.3. This result is mostly driven by reductions in violent hate-crimes. There is also evidence of a reduction in property hate-crimes. Additional analyses indicate that the effect is stronger in counties with a large share of likely perpetrators. Our results show suggestive evidence that same-sex marriage bans have the opposite effect on the LGBT hate-crime rate. The results demonstrate that salient LGBT-specific policy announcements are effective at reducing hate-crimes based on sexual orientation.
Cesarean sections (C-sections) are the most frequently performed surgery in developed countries. This paper examines the health and health utilization effects of C-sections for babies and their mothers. Because of the non-randomness of C-sections, I use exogenous variation in the position of the fetus at the time of delivery to instrument for treatment. Using administrative data from South Carolina, I exploit the breech position, in which the fetus is positioned with its head upwards instead of downwards, to isolate variation in C-sections that is uncorrelated with the ex-ante health of the infant and mother. I find that a C-section increases the probability of abnormal conditions for babies immediately after birth. However, there are no significant effects on babies' future health conditions after birth. Mothers who deliver by C-section have fewer complications at birth and are less likely to develop postpartum depression after birth. I also document a significant drop in future fertility. Although the length of stay at the hospital and hospital charges increase for babies and mothers, mothers benefit from a C-section, and babies are not made worse off in marginal cases where the decision to have a C-section is left to the baby who chooses to be upside-down.
We investigate contests with entry fees in an experimental laboratory. We find overspending for all entry fees; under - participation for low entry fees; over - participation for high entry fees; and the optimal entry fee for the contest designer. The optimal experimental entry fee is much higher than the theoretical one.
We investigate whether offering physicians financial incentives for undertaking physical activity influences their participation in exercise, wellbeing (measured as burnout), delivery of quality health care, patient experience scores, clinical productivity, and academic productivity. In Fiscal Year 2019, Prisma Health, the largest not-for-profit health organization in South Carolina, offered Emergency Medicine providers financial incentives for exercise as part of their variable compensation. It is the first time that any Prisma Health department has offered providers financial compensation for undertaking physical activity. In addition, to the best of our knowledge, this is the first study evaluating the impact of offering financial incentives for exercise on provider wellbeing, clinical quality, and other named productivity and patient experience outcomes. Our finding shows that controlling for provider characteristics (e.g. full/part-time status, nocturnist/non-nocturnist, age, gender) and the number of exercises in FY2019 and average duration of the exercises; holding all else constant, a one-unit increase in the number of different types of exercises in FY2019 generates a 0.0783 percentage point decrease in the probability of burnout and a 0.0877 unit increase in professional fulfillment.
Physicians practice "defensive medicine" when they perform unnecessary procedures on patients to protect themselves from malpractice lawsuits. Defensive medicine generates as much as $45.6 billion in annual waste. This study explores the predictors of defensive medicine. We focus on the role of feeling threatened by a patient complaint. Our empirical strategy is to measure how physicians respond when a co-worker is reported by one of his or her patients. We execute this analysis by obtaining the universe of complaints filed against Florida physicians in 2000-2014 and linking these to Florida hospital discharge records. Hospital discharge records contain detailed information on the procedures patients receive and the specific physicians who perform the procedures, allowing us to identify post-complaint behavioral changes among peer physicians.