Abstract
The recent rapid increase in cesarean childbirth is a source of growing public health concern. We suggest that one method of ameliorating the rise would be to disseminate hospital-specific cesarean section rates. To make such rates comparable between hospitals, it is necessary to adjust for variations in maternal and newborn factors associated with cesarean section. We therefore applied an indirect standardization technique to three years of California vital records data. The results show sizable variations in cesarean section rates among individual hospitals and by hospital type, both before and after standardization. For such a method to be effective, complete and accurate information from birth certificates is an obvious prerequisite.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Hexter A. C., Winkelstein W., Jr California's new birth certificate law: a model for the nation? Am J Public Health. 1979 Jul;69(7):704–705. doi: 10.2105/ajph.69.7.704. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hexter A. C., Winkelstein W., Jr California's new birth certificate law: a model for the nation? Am J Public Health. 1979 Jul;69(7):704–705. doi: 10.2105/ajph.69.7.704. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Petitti D. B., Cefalo R. C., Shapiro S., Whalley P. In-hospital maternal mortality in the United States: time trends and relation to method of delivery. Obstet Gynecol. 1982 Jan;59(1):6–12. [PubMed] [Google Scholar]
- Petitti D., Olson R. O., Williams R. L. Cesarean section in California--1960 through 1975. Am J Obstet Gynecol. 1979 Feb 15;133(4):391–397. doi: 10.1016/0002-9378(79)90058-9. [DOI] [PubMed] [Google Scholar]
- Wennberg J., Gittelsohn A. Variations in medical care among small areas. Sci Am. 1982 Apr;246(4):120–134. doi: 10.1038/scientificamerican0482-120. [DOI] [PubMed] [Google Scholar]
- Williams R. L., Chen P. M. Identifying the sources of the recent decline in perinatal mortality rates in California. N Engl J Med. 1982 Jan 28;306(4):207–214. doi: 10.1056/NEJM198201283060404. [DOI] [PubMed] [Google Scholar]