Table 5. Multiple logistic regression analysis.
Outcome: length of hospital htay (LoS) longer than ED benchmarks (2 days for spontaneous vaginal deliveries; 3 days for instrumental vaginal deliveries). Effect estimates for hospital and calendar year adjusted for all other factors. Adjusted odds ratios (aOR*) and population attributable risks (PAR1$, PAR2,** PAR3,$ PAR4**) with 95% confidence intervals (95%CI). NA = Not available; observations = complete (case analysis) observations.
| FACTORS | STRATA | VAGINAL DELIVERY MODE | |||||
|---|---|---|---|---|---|---|---|
| SPONTANEOUS | INSTRUMENTAL | ||||||
| aOR (95%CI) (LoS >2 vs. ≤ 2) (73,281 observations) |
PAR1 (95%CI) | PAR2 (95%CI) | aOR (95%CI) (LoS >3 vs. ≤ 3) (7,050 observations) |
PAR3 (95%CI) | PAR4 (95%CI) | ||
| HOSPITAL | A | reference | reference | reference | reference | reference | reference |
| B | 89.38 (78.49; 101.78) | +64.5% (+63.4%; +65.6%) | +65.8% (+64.6%; +67.0%) | 7.90 (6.38; 9.78) | +44.8% (+41.0%; +48.5%) | +43.2% (+39.4%; +46.9%) | |
| C | 4.86 (4.51; 5.23) | +37.5% (+35.9%; +39.0%) | +38.1% (+36.5%; +39.7%) | 0.83 (0.59; 1.17) | -0.0% (-5.2%; +4.3) | -0.3% (-4.3%; +3.7.%) | |
| D | 26.47 (22.35; 31.46) | +59.0 (+57.5%; +60.6%) | +60.2% (+58.6%; +61.8%) | 7.85 (5.08; 12.12) | +44.7% (+35.1%; +53.4%) | +43.0 (+33.0%; +52.1%) | |
| E | 8.40 (7.68; 9.19) | +46.7% (+45.1%; +48.2%) | +47.5 (+45.9%; +49.1%) | 2.21 (1.67; 2.94) | +16.1% (+10.7%; +21.5%) | +14.5% (+9.5%; +19.4%) | |
| F | 2.93 (2.69; 3.20) | +27.4% (+25.6%; +29.3%) | +27.9% (+26.0%; +29.8%) | 0.79 (0.58; 1.08) | -1.1% (-5.2%; +3.1%) | -1.0 (-4.3%; +2.8%) | |
| G | 0.77 (0.72; 0.83) | -1.0 (-2.2; +1.0%) | -1.0% (-2.1%; +1.0%) | 0.72 (0.56; 0.95) | -2.2% (-5.7%; +1.4%) | -1.7 (-4.7%; +1.3%) | |
| H | 2.78 (2.61; 2.96) | +26.3% (+24.8; +27.7%) | +26.7% (+25.2%; +28.2%) | 1.53 (1.21; 1.94) | +9.0% (+5.0%; +13.0%) | +7.9% (+4.4%; +11.4%) | |
| I | 10.42 (9.49; 11.44) | +49.7% (+48.2%; +51.2%) | +50.6% (+49.0%; +52.1%) | 2.85 (2.15; 3.78) | +21.5% (+15.8%; +27.1%) | +19.6% (+14.2%; +24.9%) | |
| J | 2.39 (2.24; 2.55) | +23.1% (+21.6%; +24.6%) | +23.5% (+22.0%; +25.0%) | 2.56 (2.03; 3.23) | +19.2% (+14.8; +23.5%) | +17.3% (+13.4%; +21.3%) | |
| K | 10.30 (9.45 11.21) | +49.5% (+48.1%; +51.0) | +50.4% (+48/9%; +51.9%) | 2.41 (1.88; 3.10) | +17.9% (+13.2%; +22.5%) | +16.1% (+11.8%; +20.4%) | |
| L | NA | NA | NA | NA | NA | NA | |
| Calendar year (2005–2015) | 0.96 (0.95; 0.96) | 0.97 (0.95; 0.99) | |||||
* Multiple logistic regression model adjusted for: Health care setting and time-frame factors (hospital and calendar year); Maternal health factors (mother’s age; hypertension/diabetes; amniocentesis; number of obstetric checks; number of ultrasound scans performed; no labour induction; labour analgesia; neonatal status; presentation; pre-delivery LoS); Child’s fragility factors (Apgar score at 5 minutes; ICU admission; multiple birth); Child’s size factors (gestational age; birthweight; placenta weight); Obstetric history factors (parity; history of caesarean sections); Socio-demographic factors (father’s age; mother’s nationality; mother’s educational level)
$ Population Attributable Risk 1 (PAR 1) and 3 (PAR 3). Proportional variation of LoS < ED after childbirth in the ideal scenario each hospital would be performing as hospital A during calendar year 2015
** Population Attributable Risk 2 (PAR 2) and 4 (PAR4). Proportional variation of LoS < ED after childbirth in the ideal scenario each hospital would be performing as hospital A during calendar year 2015. Estimations of PAR2 and PAR4 calculated only for low risk pregnancies, defined as conditions of the mother and/or the newborn simultaneously meeting all the following criteria: for spontaneous vaginal deliveries (PAR 2): mother’s age<35; no resuscitation performed; child not admitted to ICU; singleton birth; Apgar score at 1 minute ≥7; Apgar score at 5 minutes ≥8; no labour induction; no women affected by hypertension/diabetes; birthweight: 2,500–3,999gr; gestational age: 37–40 weeks; pre delivery LoS ≤2 days; for instrumental vaginal deliveries (PAR 4): in addition to all above criteria, the calculation of PAR4 was restricted to women not administered with labour analgesia.