ArticleMedical care2018
Examining Trends in Obstetric Quality Measures for Monitoring Health Care Disparities.
Article in Medical care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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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.
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Who cites it
7 citing papers in PubMed.
- Racial and Ethnic Trends in Cesarean Delivery on Maternal Request.Journal of racial and ethnic health disparities · 2026Article
- Inequalities in cesarean births between American Indian & Alaska Native people and White people.Health services research · 2023Article
- Risk factors and pregnancy outcomes vary among Asian American, Native Hawaiian, and Pacific Islander individuals giving birth in California.Annals of epidemiology · 2022Article
- Hospital Quality of Care and Racial and Ethnic Disparities in Unexpected Newborn Complications.Pediatrics · 2021Article
- Cesarean birth and maternal morbidity among Black women and White women after implementation of a blended payment policy.Health services research · 2020Article
- A Systematic Review of Racial and Ethnic Disparities in Maternal Health Outcomes among Asians/Pacific Islanders.Asian/Pacific Island nursing journal · 2020Article
- "Just Because You Have Ears Doesn't Mean You Can Hear"-Perception of Racial-Ethnic Discrimination During Childbirth.Ethnicity & disease · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundElective delivery (ED) before 39 weeks, low-risk cesarean delivery, and episiotomy are routinely reported obstetric quality measures and have been the focus of quality improvement initiatives over the past decade.
objectiveTo estimate trends and differences in obstetric quality measures by race/ethnicity. RESEARCH
designWe used 2008-2014 linked birth certificate-hospital discharge data from New York City to measure ED before 39 gestational weeks (ED <39), low-risk cesarean, and episiotomy by race/ethnicity. Measures were following the Joint Commission and National Quality Forum specifications. Average annual percent change (AAPC) was estimated using Poisson regression for each measure by race/ethnicity. Risk differences (RD) for non-Hispanic black women, Hispanic women, and Asian women compared with non-Hispanic white women were calculated.
resultsED<39 decreased among whites [AAPC=-2.7; 95% confidence interval (CI), -3.7 to -1.7), while it increased among blacks (AAPC=1.3; 95% CI, 0.1-2.6) and Hispanics (AAPC=2.4; 95% CI, 1.4-3.4). Low-risk cesarean decreased among whites (AAPC=-2.8; 95% CI, -4.6 to -1.0), and episiotomy decreased among all groups. In 2008, white women had higher risk of most measures, but by 2014 incidence of ED<39 was increased among Hispanics (RD=2/100 deliveries; 95% CI, 2-4) and low-risk cesarean was increased among blacks (RD=3/100; 95% CI, 0.5-6), compared with whites. Incidence of episiotomy was lower among blacks and Hispanics than whites, and higher among Asian women throughout the study period.
conclusionsExisting measures do not adequately assess health care disparities due to modest risk differences; nonetheless, continued monitoring of trends is warranted to detect possible emergent disparities.
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