产前护理真的无效吗？还是说，“问题”出在其分配上？

Is prenatal care really ineffective? Or, is the 'devil' in the distribution?

作者信息

Conway Karen Smith, Deb Partha

机构信息

Department of Economics, University of New Hampshire, Durham, 03824, USA.

出版信息

J Health Econ. 2005 May;24(3):489-513. doi: 10.1016/j.jhealeco.2004.09.012.

DOI:10.1016/j.jhealeco.2004.09.012

PMID:15811540

Abstract

Prenatal care should improve infant health, yet research frequently finds only weak effects. If there are two kinds of pregnancies, 'complicated' and 'normal' ones, then combining these pregnancies may lead prenatal care to appear ineffective. Data from the National Maternal and Infant Health Survey (NMIHS) offers compelling evidence. The standard 2SLS approach yields obviously bimodal residuals and frequently insignificant prenatal care coefficients. In contrast, estimating birth weights with a finite mixture model yields estimates revealing that prenatal care has a substantial effect on 'normal' pregnancies. Our Monte Carlo experiment confirms that ignoring even a small proportion of 'complicated' pregnancies can lead prenatal care to appear unimportant.

摘要

产前护理本应改善婴儿健康状况，但研究常常发现其效果甚微。如果存在“复杂”和“正常”两种类型的孕期，那么将这两种孕期情况合并起来可能会导致产前护理显得无效。来自全国母婴健康调查（NMIHS）的数据提供了有力证据。标准的两阶段最小二乘法（2SLS）得出的残差明显呈双峰分布，且产前护理系数常常不显著。相比之下，用有限混合模型估计出生体重得出的结果表明，产前护理对“正常”孕期有显著影响。我们的蒙特卡洛实验证实，即使忽略一小部分“复杂”孕期情况，也可能会使产前护理显得不重要。