The effect of co-payments on the take-up of prenatal tests.

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Publisher: Elsevier B.V.
Document Type: Report; Brief article
Length: 255 words

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Keywords Prenatal tests; Co-payments; Maternal and newborn health; Regression discontinuity design Abstract Noninvasive prenatal screening tests help identify genetic disorders in a fetus, but their take-up remains low in several countries. Using a regression discontinuity design, we test the causal effect of a policy that eliminated co-payments for noninvasive screening tests in Italy. We identify the treatment effects by a discontinuity in women's eligibility for a free test based on their conception date. We find that the policy increases the probability of women's undergoing noninvasive screening tests by 5.5 percentage points, and the effect varies by socioeconomic status. We do not find evidence of substitution effects with more expensive and riskier invasive diagnostic tests. In addition, the increase in take-up does not affect pregnancy termination or newborn health. We find some evidence of positive effects on mothers' health behaviors during pregnancy as measured by reductions in mothers' weight gain and hospital admissions during pregnancy, but these are statistically significant only at the 10 percent level. Author Affiliation: (a) University of Torino, Department of Economics, Social Sciences, Applied Mathematics and Statistics (ESOMAS) (b) University of Piemonte Orientale, Department of Economics and Business (DISEI), Novara, Italy (c) University of York, Department of Economics and Related Studies, York, United Kingdom (d) Università Cattolica del Sacro Cuore, Department of Economics and Finance, Rome, Italy * Corresponding author. Article History: Received 13 January 2021; Revised 29 October 2021; Accepted 1 November 2021 Byline: Marina Di Giacomo [marina.digiacomo@unito.it] (a), Massimiliano Piacenza [massimiliano.piacenza@uniupo.it] (b,*), Luigi Siciliani [luigi.siciliani@york.ac.uk] (c), Gilberto Turati [gilberto.turati@unicatt.it] (d)

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Gale Document Number: GALE|A690736771