Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study
<p class="Maintext"><strong>Background:</strong> The rates of cesarean deliveries have been increasing steadily in several European countries in recent decades, with Italy having the second-highest rate (38% in 2010), causing concern and debate about the appropriateness o...
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Milano University Press
2014-11-01
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| Series: | Epidemiology, Biostatistics and Public Health |
| Online Access: | http://ebph.it/article/view/10267 |
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| author | Massimo Cannas Emiliano Sironi |
| author_facet | Massimo Cannas Emiliano Sironi |
| author_sort | Massimo Cannas |
| collection | DOAJ |
| description | <p class="Maintext"><strong>Background:</strong> The rates of cesarean deliveries have been increasing steadily in several European countries in recent decades, with Italy having the second-highest rate (38% in 2010), causing concern and debate about the appropriateness of many interventions. Moreover, some recent studies suggest that rates of common obstetric interventions are not homogeneous across hospitals, maybe not only because of patient case mix but also possibly because of different hospital practices and cultures. Thus, it is important to investigate whether the variation in rates of cesarean sections can be traced back to patient characteristics or whether it depends upon context variables at the hospital level.</p><p class="Maintext"><strong> </strong></p><p class="Maintext"><strong>Objective and method:</strong> Using official hospital abstracts on deliveries that occurred in Sardinia over a two-year period, we implement multilevel logistic regression models in order to assess whether the observed differences in cesarean rates across hospitals can be justified by case-mix differences across hospitals.</p><p class="Maintext"> </p><p class="Maintext"><strong>Results:</strong> The between-hospital variation in rates of cesarean delivery is estimated to be 0.388 in the model with only the intercept and 0.382 in the model controlling for the mother’s clinical and sociodemographic characteristics.</p><p class="Maintext"> </p><p class="Maintext"><strong>Conclusions:</strong> The results show that taking into account the individual characteristics of delivered mothers is not enough to justify the observed variation across hospital rates, suggesting the important role of unobserved variables at the hospital level in determining cesarean section rates.<strong></strong></p> |
| format | Article |
| id | doaj-art-19eade8c35e544fab4f78d2f358f3fca |
| institution | DOAJ |
| issn | 2282-0930 |
| language | English |
| publishDate | 2014-11-01 |
| publisher | Milano University Press |
| record_format | Article |
| series | Epidemiology, Biostatistics and Public Health |
| spelling | doaj-art-19eade8c35e544fab4f78d2f358f3fca2025-08-20T03:16:42ZengMilano University PressEpidemiology, Biostatistics and Public Health2282-09302014-11-0111410.2427/1026710231Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational studyMassimo Cannas0Emiliano Sironi1University of CagliariUniversità Cattolica del Sacro Cuore, Milano<p class="Maintext"><strong>Background:</strong> The rates of cesarean deliveries have been increasing steadily in several European countries in recent decades, with Italy having the second-highest rate (38% in 2010), causing concern and debate about the appropriateness of many interventions. Moreover, some recent studies suggest that rates of common obstetric interventions are not homogeneous across hospitals, maybe not only because of patient case mix but also possibly because of different hospital practices and cultures. Thus, it is important to investigate whether the variation in rates of cesarean sections can be traced back to patient characteristics or whether it depends upon context variables at the hospital level.</p><p class="Maintext"><strong> </strong></p><p class="Maintext"><strong>Objective and method:</strong> Using official hospital abstracts on deliveries that occurred in Sardinia over a two-year period, we implement multilevel logistic regression models in order to assess whether the observed differences in cesarean rates across hospitals can be justified by case-mix differences across hospitals.</p><p class="Maintext"> </p><p class="Maintext"><strong>Results:</strong> The between-hospital variation in rates of cesarean delivery is estimated to be 0.388 in the model with only the intercept and 0.382 in the model controlling for the mother’s clinical and sociodemographic characteristics.</p><p class="Maintext"> </p><p class="Maintext"><strong>Conclusions:</strong> The results show that taking into account the individual characteristics of delivered mothers is not enough to justify the observed variation across hospital rates, suggesting the important role of unobserved variables at the hospital level in determining cesarean section rates.<strong></strong></p>http://ebph.it/article/view/10267 |
| spellingShingle | Massimo Cannas Emiliano Sironi Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study Epidemiology, Biostatistics and Public Health |
| title | Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study |
| title_full | Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study |
| title_fullStr | Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study |
| title_full_unstemmed | Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study |
| title_short | Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study |
| title_sort | hospital differences in rates of cesarean deliveries in the sardinian region an observational study |
| url | http://ebph.it/article/view/10267 |
| work_keys_str_mv | AT massimocannas hospitaldifferencesinratesofcesareandeliveriesinthesardinianregionanobservationalstudy AT emilianosironi hospitaldifferencesinratesofcesareandeliveriesinthesardinianregionanobservationalstudy |