Publications

Low Staffing in the Maternity Wards: Keep Calm and Call the Surgeon​  
Journal of Economic Behavior and Organization, 2022​
This paper examines how workload affects the provision of care in a large but understudied segment of the healthcare sector -- maternity wards. I use detailed patient-level administrative data on childbirth, and exploit quasi-random assignment of unscheduled patients to different staffing ratios. I find that patients who at admission observe a higher ratio of patients-to-midwives are more likely to receive a C-section. I show that this result is not attributable to patients' differential sorting across workload levels. Instead, I find evidence that C-sections are used to alleviate midwives' workload -they are faster than vaginal births and performed by physicians. I also exploit patient's civil status to determine whether the effect varies with patient's bargaining power -single women are on average more likely to be alone in the delivery room. Consistent with induced demand, only single patients are more likely to receive a C-section when admitted at high workload levels.
Forgetting-by-not-doing: The case of surgeons and cesarean sections​ 
​Health Economics, 2021​
  • Working Paper PDF 
This paper provides new evidence on the link between patient outcome and physician experience. Using birth certificates data from a large hospital in Italy, I analyze whether cesarean section surgeons who have performed more procedures in the recent past observe an improvement in performance. By using data from the Italian health care system, where patients are not allowed to choose their physician, I lower concerns of potential reverse causality (selective referral). I find evidence indicating a strong learning-by-doing effect: for emergent cases, a one standard deviation increase in recent experience reduces the likelihood of neonatal intensive care unit admission by nearly 2.9 percentage points (12%) and of being born with a low Apgar Score by about 1.3 percentage points (9.5%), all else equal. This effect is not present for the case of elective C-sections.​​
Intergroup Contact and Nation Building: Evidence from Military Service in Spain (with Julio Cáceres-Delpiano, Antoni-Italo De Moragas and Ignacio González)  
​Journal of Public Economics, 2021 
We study the long-term effects of intergroup contact on nation building by exploiting a national lottery that randomly allocated conscripts to different military areas across Spain. For men born in regions featuring a strong regional identity, we find that being assigned to military service in a region different from one's region of birth substantially increases self-identification as Spanish and reduces the likelihood of voting for a regionalist party. Moreover, in support of intergroup contact as the main mechanism behind these results, we find that movers are more likely to have friends from another region than nonmovers.​
COVID-19 Lockdown and Domestic Violence: Evidence from Internet-Search Behavior in 11 Countries
​ (with Inés Berniell) 
​European Economic Review, 2021
We study the impact of the COVID-19 pandemic on domestic violence in 11 countries with different ex-ante incidence of domestic violence (DV) and lockdown intensity. We use a novel measure of DV incidents that allows us to make cross-country comparisons: a Google search intensity index of DV-related topics. Our difference-indifference estimates show an increase in DV search intensity after lockdown (31%), with larger effects as more people stayed at home (measured with Google Mobility Data). The peak of the increase in DV appears, on average, 7 weeks after the introduction of the lockdown. While we observe that the positive impacts on DV is a widespread phenomenon, the effect in developed countries is more than twice as strong as in Latin American countries. We show that the difference in impact correlates with the intensity of compliance with stay-at-home measures in the two groups.

Working Papers

Productivity Effects of Dengue in Brazil. [PDF]
(with Sonia Bhalotra, Aline Menezes and Rudi Rocha) 
​Although understanding the role of health in driving labor market outcomes is a matter of great importance, it has proven difficult to isolate this effect due to empirical challenges and a lack of compelling sources of identification. We obtain causal estimates of the effect of health on income and welfare dependency through two different channels: a negative health shock (dengue outbreak) and a positive health shock (opening of a health-care facility). To do this, we rely on instrumental variables and difference-in-difference methods, as well as on novel datasets. We find that dengue outbreaks lower the average working hours and income. This effect is particularly high for low-income individuals, but conditional cash transfer programs can insulate them from this shock. On the other hand, the opening of a new health-care facility in a families catchment area rises family per capita income and employment. All together, this evidence suggest that health shocks are an important part of income, poverty and welfare dependency.​

Work in Progress

The Effects of Cesarean Delivery on Mother's Fertility and Children's Long-term Health.  (with Matilde Machado and Chiara Serra)

Better Together? Bolsa Familia, School Segregation and Learning Outcomes.  (with Gabriela Galassi)