Evidence map›Paper›PMID 27392410›Full record

ArticleBMC health services research2016

Differences in nulliparous caesarean section rates across models of care: a decomposition analysis.

Aoife Brick, Richard Layte, Anne Nolan, Michael J Turner

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Aoife BrickEconomic and Social Research Institute, Whitaker Square, Sir John Rogerson`s Quay, Dublin 2, Ireland. aoife.brick@esri.ie.ORCID 0000-0002-5046-8336
Richard LayteEconomic and Social Research Institute, Whitaker Square, Sir John Rogerson`s Quay, Dublin 2, Ireland.
Anne NolanEconomic and Social Research Institute, Whitaker Square, Sir John Rogerson`s Quay, Dublin 2, Ireland.
Michael J TurnerUCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
Economic and Social Research Institute · IECoombe Women & Infants University Hospital · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo evaluate the extent of the difference in elective (ELCS) and emergency (EMCS) caesarean section (CS) rates between nulliparous women in public maternity hospitals in Ireland by model of care, and to quantify the contribution of maternal, clinical, and hospital characteristics in explaining the difference in the rates.

methodsCross-sectional analysis using a combination of two routinely collected administrative databases was performed. A non-linear extension of the Oaxaca-Blinder method is used to decompose the difference between public and private ELCS and EMCS rates into the proportion explained by the differences in observable maternal, clinical, and hospital characteristics and the proportion that remains unexplained.

resultsOf the 29,870 babies delivered to nulliparous women, 7,792 were delivered via CS (26.1 %), 79.6 % of which were coded as EMCS. Higher prevalence of ELCS was associated with breech presentation, other malpresentation, and the mother being over 40 years old. Higher prevalence of EMCS was associated with placenta praevia or placental abruption, diabetes (pre-existing and gestational), and being over 40 years old. The private model of care is associated with ELCS and EMCS rates 6 percentage points higher compared than the public model of care but this differential is insignificant in the fully adjusted models for EMCS. Just over half (53 %) of the 6 percentage point difference in ELCS rates between the two models of care can be accounted for by maternal, clinical and hospital characteristics. Almost 80 % of the difference for EMCS can be accounted for.

conclusionsThe majority of the difference in EMCS rates across models of care can be explained by differing characteristics between the two groups of women. The main contributor to the difference was advancing maternal age. The unexplained component of the difference for ELCS is larger; an excess private effect remains after accounting for maternal, clinical, and hospital characteristics. This requires further investigation and may be mitigated in future with the introduction of clinical guidelines related to CS.

Indexed as

Delivery of Health CareParityAdultCesarean SectionCross-Sectional StudiesDatabases, FactualElective Surgical ProceduresFemaleHospitals, PublicHumansIrelandMaternal AgePregnancyYoung AdultElective caesarean sectionEmergency caesarean sectionNon-linear Oaxaca–Blinder decomposition methodPrivate practice

Identifiers

PMID27392410
PMCPMC4938942
OpenAlexW2461973199

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.