Obstetric interventions in two groups of hospitals in Catalonia: a cross-sectional study

BMC Pregnancy and Childbirth

Vicente Ortún⁵  Josep Fusté¹  Xavi Espada⁴  Joanna White⁶  Isabel Espiga²  Cristina Colls⁷  Herminia Biescas¹  María Pueyo¹  Ramón Escuriet³ 

[1] Directorate-General for Health Planning and Research, Ministry of Health of the Government of Catalonia, Barcelona, Spain;Observatory on Women’s Health, Subdirectorate for Quality and Cohesion, Ministry of Health, Social Services and Equality, Madrid, Spain;Directorate-General for Health Planning and Research, Ministry of Health of the Government of Catalonia, Pompeu Fabra University, Travessera de les Corts, 131-159, Pavelló Ave Maria, Barcelona, 08028, Spain;Fundació Hospital Asil de Granollers, Granollers, Spain;Faculty of Economic and Business Sciences, Pompeu Fabra University, Barcelona, Spain;Visiting Fellow, King’s College London, London, UK;Catalan Agency for Health Information, Assessment and Quality, Barcelona, Spain

关键词: Hospital birth;    Variability;    Caesarean section;    Obstetric intervention;   

Others  :  1127414
DOI  :  10.1186/1471-2393-14-143

 received in 2013-07-25, accepted in 2014-04-03,  发布年份 2014

【 摘 要 】

Background

Childbirth assistance in highly technological settings and existing variability in the interventions performed are cause for concern. In recent years, numerous recommendations have been made concerning the importance of the physiological process during birth. In Spain and Catalonia, work has been carried out to implement evidence-based practices for childbirth and to reduce unnecessary interventions.

To identify obstetric intervention rates among all births, determine whether there are differences in interventions among full-term single births taking place in different hospitals according to type of funding and volume of births attended to, and to ascertain whether there is an association between caesarean section or instrumental birth rates and type of funding, the volume of births attended to and women’s age.

Methods

Cross-sectional study, taking the hospital as the unit of analysis, obstetric interventions as dependent variables, and type of funding, volume of births attended to and maternal age as explanatory variables. The analysis was performed in three phases considering all births reported in the MBDS Catalonia 2011 (7,8570 births), full-term single births and births coded as normal.

Results

The overall caesarean section rate in Catalonia is 27.55% (CI 27.23 to 27.86). There is a significant difference in caesarean section rates between public and private hospitals in all strata. Both public and private hospitals with a lower volume of births have higher obstetric intervention rates than other hospitals (49.43%, CI 48.04 to 50.81).

Conclusions

In hospitals in Catalonia, both the type of funding and volume of births attended to have a significant effect on the incidence of caesarean section, and type of funding is associated with the use of instruments during delivery.

【 授权许可】

   
2014 Escuriet et al.; licensee BioMed Central Ltd.

【 图 表 】

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