Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/319895 
Year of Publication: 
2025
Series/Report no.: 
ZEW Discussion Papers No. 25-025
Publisher: 
ZEW - Leibniz-Zentrum für Europäische Wirtschaftsforschung, Mannheim
Abstract: 
Maternity unit closures are increasingly common in areas with low birth rates, resulting in diminished competition between units. We examine how competition affects the quality and amenities of the remaining maternity units in Germany. To address potential endogeneity in the level of competition, we exploit the unpopularity of maternity unit closures and instrument competition with the tightness of past regional elections. Our findings indicate that while low competition does not significantly affect the quality of care, it leads to reduced availability of additional services potentially used to attract patients in the higher competitive market.
Subjects: 
Maternity unis
hospital competition
healthcare quality
non-price amenities
JEL: 
I11
I18
L13
Document Type: 
Working Paper

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