Is there 'patient selection' in the demand for private maternity care in Greece?

The influence of private health insurance (PHI) and gynaecologists' demand for leisure in determining a caesarean section (CS) delivery is examined. A database collected in January 2002 is exploited which contains records on women who attended the second largest private hospital in Greece. A joint maximum-likelihood probit estimation for the PHI subscription and the decision to undertake CS is employed. Results suggest that the obstetrician's decision to undertake CS is not independent of the women having PHI coverage. The probability of a CS taking place increases by about 20% if mothers have PHI. Furthermore, CS deliveries were more likely to take place between 12.00 and 16.00 pm and on working week days and Saturdays. The results support the hypothesis of patient selection on the basis of holding PHI and exhibit evidence of gynaecologists' 'demand for leisure'.