Non-elective C-sections in public hospitals: capacity constraints and doctor incentives

Using administrative records of births from the Perinatal Surveillance System of the Peruvian Social Security System (ESSALUD), we test whether high admissions of pregnant women affected non-elective caesarean section (C-section) rates in the ESSALUD public hospitals during 2005–2006. We present a basic theoretical model that considers physician preferences for leisure and hospital capacity constraints, and test the model predictions. We find that physician demand for leisure increases the probability of C-sections in small and medium-size hospitals, while hospital capacity constraints set a limit on them. We discuss the policy implications as well as the policies implemented to avoid unnecessary C-sections.