Details:

Alternative Title:
PLoS One
Publisher's site:
http://dx.doi.org/10.1371/journal.pone.0057817
Personal Author:
Cáceres, Isabel A. ; Arcaya, Mariana ; Declercq, Eugene ; Belanoff, Candice M. ; Janakiraman, Vanitha ; ... More +
Cáceres, Isabel A. ; Arcaya, Mariana ; Declercq, Eugene ; Belanoff, Candice M. ; Janakiraman, Vanitha ; Cohen, Bruce ; Ecker, Jeffrey ; Smith, Lauren A. ; Subramanian, S. V. ; Less -
Description:
Objective We examined the extent to which differences in hospital-level cesarean delivery rates in Massachusetts were attributable to hospital-level, rather than maternal, characteristics. Methods Birth 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 Results Overall, 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). Conclusion Even 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.
Subject:
[+]
Adult
Artifacts
Cesarean Section
Databases, Factual
Diagnosis-Related Groups
Female
Hospitals
Humans
Infant, Newborn
Logistic Models
Pregnancy

Source:
PLoS One. 2013; 8(3).
Pubmed ID:
23526952
Pubmed Central ID:
PMC3601117
Document Type:
Journal Article ;
Funding:
200-2009-31671CDC/CD/ODCDC CDC HHS/United States ; 3R25CA057711-18S1/CA/NCI NIH HHS/United States ; K25 HL081275/HL/NHLBI NIH HHS/United States ;
200-2009-31671CDC/CD/ODCDC CDC HHS/United States ; 3R25CA057711-18S1/CA/NCI NIH HHS/United States ; K25 HL081275/HL/NHLBI NIH HHS/United States ; Less -
Place as Subject:
Massachusetts ;
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:34d5eda752b9e97799a3f66a238426cea8ab3086351f8b40392d37a222c44c3a
File Type:

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