In Uruguay, like in the rest of the world, the rate of births through Caesarian section has been increasing steadily. In 2003 in Montevideo, 23,474 births were registered by the Prenatal Information System (PIS). Of these, 23% were in public hospitals and 42% in private establishments. These data are used to estimate the probability of having a Caesarian section delivery, controlled by risk factors and the endogeneity of the choice of hospital. In public hospitals in Montevideo there is a fixed payment system, but in private hospitals this procedure has to be paid for separately. In the former, there is no effect on the doctor’s income if he performs a Caesarian, but in the latter there is a positive effect. Empirical evidence shows that there is a 20% probability of a woman in a public hospital having a Caesarian section delivery, but in private hospitals the figure is 39%. These differences between the two types of hospitals are greater for lower-risk women. For example, the probability of having a Caesarian section among women considered to be at no medical risk is more than twice as high in private hospitals (25 per cent versus 11 per cent).
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