ArticlePloS one2013
Hospital differences in cesarean deliveries in Massachusetts (US) 2004-2006: the case against case-mix artifact.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Caesarean sections in teaching hospitals: systematic review and meta-analysis of hospitals in 22 countries.BMJ open · 2021Pooled it
- Caesarean section in uninsured women in the USA: systematic review and meta-analysis.BMJ open · 2019Pooled it
- Impact of an educational program and decision tool on choice of maternity hospital: the delivery decisions randomized clinical trial.BMC pregnancy and childbirth · 2022Trial
- Does comparing cesarean delivery rates influence women's choice of obstetric hospital?The American journal of managed care · 2019Trial
- The Association Between Experiencing Racial Discrimination and Delivery Method Among Women in the United States, PRAMS 2016-2021.Journal of racial and ethnic health disparities · 2026Article
- Can Birth Hospital Explain Racial/Ethnic Differences in Cesarean Birth Among Low-Risk Births? An Analysis of California Data, 2007-2018.Journal of racial and ethnic health disparities · 2026Article
- Using linked data to explore medical complications associated with Robson classification of cesarean deliveries in Massachusetts, 2011 to 2018.AJOG global reports · 2025Article
- Evaluation of Statewide Program to Reduce Cesarean Deliveries Among Nulliparous Individuals With Singleton Pregnancies at Term Gestation in Vertex Presentation.Obstetrics and gynecology · 2024Article
- Hospital-level variation in racial disparities in low-risk nulliparous cesarean delivery rates.American journal of obstetrics & gynecology MFM · 2023Article
- Exploring the impact of indication on variation in rates of intrapartum caesarean section in six Palestinian hospitals: a prospective cohort study.BMC pregnancy and childbirth · 2022Article
- Improving communication and teamwork during labor: A feasibility, acceptability, and safety study.Birth (Berkeley, Calif.) · 2022Article
- Obstetric and Neonatal Outcomes 1 or More Years After a Diagnosis of Breast Cancer.Obstetrics and gynecology · 2022Article
- Implementation strategies within a complex environment: A qualitative study of a shared decision-making intervention during childbirth.Birth (Berkeley, Calif.) · 2022Article
- Office hours and caesarean section: systematic review and Meta-analysis.Research in health services & regions · 2022Review
- Article
- Demonstration of the application of the global cesarean section rate model (C-Model) and the Robson Classification to estimate and characterize excess numbers of institutional c-sectionsRevista colombiana de obstetricia y ginecologia · 2021Article
- Observational
- Assessing the regional policies of Italian regions in managing the Cesarean delivery phenomenon: a fractal analysis.Acta bio-medica : Atenei Parmensis · 2021Article
- Multi-level Drivers of Disparities in Hispanic Cesarean Delivery Rates in US-Mexico Border States.Journal of racial and ethnic health disparities · 2020Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectiveWe examined the extent to which differences in hospital-level cesarean delivery rates in Massachusetts were attributable to hospital-level, rather than maternal, characteristics.
methodsBirth certificate and maternal in-patient hospital discharge records for 2004-06 in Massachusetts were linked. The study population was nulliparous, term, singleton, and vertex births (NTSV) (n = 80,371) in 49 hospitals. Covariates included mother's age, race/ethnicity, education, infant birth weight, gestational age, labor induction (yes/no), hospital shift at time of birth, and preexisting health conditions. We estimated multilevel logistic regression models to assess the likelihood of a cesarean delivery.
resultsOverall, among women with NTSV births, 26.5% births were cesarean, with a range of 14% to 38.3% across hospitals. In unadjusted models, the between-hospital variance was 0.103 (SE 0.022); adjusting for demographic, socioeconomic and preexisting medical conditions did not reduce any hospital-level variation 0.108 (SE 0.023).
conclusionEven after adjusting for both socio-demographic and clinical factors, the chance of a cesarean delivery for NTSV pregnancies varied according to hospital, suggesting the importance of hospital practices and culture in determining a hospital's cesarean rate.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.