Table 3.

Adjusted odds ratios (AORs) of differences by payer, annual time trends, and differential time trends by primary payer for obstetric procedures

Self-pay (vs. any third party payer) N = 6,712,181
	Primary payer=self			Annual time trend			Differential annual time trend for self–pay (vs. insured)
	AOR	95% CI		AOR	95% CI		AOR	95% CI
Cesarean delivery	0.70	0.69	0.72	1.05	1.05	1.05	1.00	0.99	1.00
Vaginal birth after cesarean (VBAC)	1.63	1.54	1.72	0.89	0.88	0.89	0.99	0.98	1.01
Labor induction	0.66	0.65	0.68	1.04	1.03	1.04	1.01	1.01	1.02
Episiotomy	0.89	0.87	0.91	0.89	0.89	0.89	0.99	0.98	1.00

Among insured births, primary payer=Medicaid (vs. private) N = 6,471,067
	Primary payer=Medicaid			Annual time trend			Differential annual time trend for Medicaid (vs. private)
	AOR	95% CI		AOR	95% CI		AOR	95% CI
Cesarean delivery	0.91	0.90	0.91	1.06	1.06	1.06	0.99	0.99	0.99
Vaginal birth after cesarean (VBAC)	1.20	1.17	1.23	0.88	0.88	0.89	1.00	0.99	1.00
Labor induction	0.73	0.73	0.74	1.03	1.03	1.03	1.03	1.03	1.03
Episiotomy	0.62	0.62	0.63	0.89	0.89	0.89	1.01	1.01	1.02

Note: All models use standard errors adjusted for hospital clustering and control for age, race, diabetes, hypertension, preeclampsia, eclampsia, multiple gestation, pregnancy exceeding 40 weeks gestation, placenta complications, fetal malpresentation, fetal disproportion, preterm delivery, prior cesarean delivery, hospital bed size, teaching status, and rural versus urban location. Bold type indicates statistical significance at P < .05. 95% CI, 95% confidence interval.