ArticleJournal of epidemiology and community health2000
Inter-hospital variations in caesarean sections. A risk adjusted comparison in the Valencia public hospitals.
Article in Journal of epidemiology and community health, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Caesarean section in uninsured women in the USA: systematic review and meta-analysis.BMJ open · 2019Pooled it
- Office hours and caesarean section: systematic review and Meta-analysis.Research in health services & regions · 2022Review
- Article
- Differences in rates and odds for emergency caesarean section in six Palestinian hospitals: a population-based birth cohort study.BMJ open · 2018Article
- Risk factors and between-hospital variation of caesarean section in Denmark: a cohort study.BMJ open · 2018Article
- Predictive modeling of emergency cesarean delivery.PloS one · 2018Article
- Korean National Health Insurance value incentive program: achievements and future directions.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2012Article
- The influence of both individual and area based socioeconomic status on temporal trends in Caesarean sections in Scotland 1980-2000.BMC public health · 2011Article
- Variation in rates of caesarean section among English NHS trusts after accounting for maternal and clinical risk: cross sectional study.BMJ (Clinical research ed.) · 2010Article
- Is generalized maternal optimism or pessimism during pregnancy associated with unplanned cesarean section deliveries in China?Journal of pregnancy · 2010Article
- Risk-adjusted cesarean section rates for the assessment of physician performance in Taiwan: a population-based study.BMC public health · 2006Article
- Risk adjustment for inter-hospital comparison of primary cesarean section rates: need, validity and parsimony.BMC health services research · 2006Article
- [Differences in the likelihood of caesareans, associated with dependency on hospitals, the volume of cases and the obstetric risk].Atencion primaria · 2003Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to describe the variability in caesarean rates in the public hospitals in the Valencia Region, Spain, and to analyse the association between caesarean sections and clinical and extra-clinical factors.
methodsAnalysis of data contained in the Minimum Basic Data Set (MBDS) compiled for all births in 11 public hospitals in Valencia during 1994-1995 (n=36 819). Bivariate and multivariate analyses were used to evaluate the association between caesarean section rates and specific risk factors. The multivariate model was used to construct predictions about caesarean rates for each hospital, for comparison with rates observed.
resultsCaesarean rates were 17.6% (inter-hospital range: 14.7% to 25.0%), with ample variability between hospitals in the diagnosis of maternal-fetal risk factors (particularly dystocia and fetal distress), and the indication for caesarean in the presence of these factors. Multivariate analysis showed that maternal-fetal risk factors correlated strongly with caesarean section, although extra-clinical factors, such as the day of the week, also correlated positively. After adjusting for the risk factors, the inter-hospital variation in caesarean rates persisted.
conclusionsAlthough certain limitations (imprecision of some diagnoses and information biases in the MBDS) make it impossible to establish unequivocal conclusions, results show a high degree of variability among hospitals when opting for caesarean section. This variability cannot be justified by differences in obstetric risks.
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