Variation in the rates of operative delivery in the United States - 22/08/11
Résumé |
Objectives |
This study was undertaken to examine the national and regional rates of operative delivery among almost one quarter million births in a single year in the nation’s largest healthcare delivery system, using variation as an arbiter of the quality of decision making.
Study Design |
We compared the variation in rates of primary cesarean and operative vaginal delivery in facilities of the Hospital Corporation of America during the year 2004.
Results |
In 124 facilities representing almost 220,000 births during a 1-year period, the primary cesarean and operative vaginal delivery rates were 19% ± 5% (range 9-37) and 7% ± 4% (range 1-23). Within individual geographic regions, we consistently found variations of 200-300% in rates of primary cesarean delivery and variations approximating an order of magnitude for operative vaginal delivery.
Conclusion |
Within broad upper and lower limits, rates of operative delivery in the United States are highly variable and suggest a pattern of almost random decision making. This reflects a lack of sufficient reliable, outcomes-based data to guide clinical decision making.
Le texte complet de cet article est disponible en PDF.Key words : cesarean delivery, operative vaginal delivery, quality of care
Plan
| Cite this article as: Clark SL, Belfort MA, Hankins GDV, et al. Variation in the rates of operative delivery in the United States. Am J Obstet Gynecol 2007;196:526.e1-526.e5. Reprints not available from the authors. |
Vol 196 - N° 6
P. 526.e1-526.e5 - juin 2007 Retour au numéro
Article précédent
- Untreated asymptomatic group B streptococcal bacteriuria early in pregnancy and chorioamnionitis at delivery
- Brenna L. Anderson, Hyagriv N. Simhan, Kathryn M. Simons, Harold C. Wiesenfeld
- Modified classification of Gram-stained vaginal smears to predict spontaneous preterm birth: a prospective cohort study
- Hans Verstraelen, Rita Verhelst, Kristien Roelens, Geert Claeys, Steven Weyers, Ellen De Backer, Mario Vaneechoutte, Marleen Temmerman
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?