Decreasing the cesarean section rate in a private hospital: Success without mandated clinical changes

Lagrew, David C.; Morgan, Mark A.

doi:10.1016/s0002-9378(96)70392-7

Cited by 79 publications

(52 citation statements)

References 19 publications

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“…Payment mechanisms to physicians and hospitals have also been shown to be one of key elements in multifaceted approaches that have proven effective in reducing CD rates in some cases [58,59] .…”

Section: Reforming Payment Mechanismsmentioning

confidence: 99%

Factors associated with high Cesarean deliveries in China and Brazil - A Call for reducing elective surgeries in moving towards Universal Health Coverage

Hou¹,

Rakhshani

Iunes³

2014

JHA

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Background: Annually 6.2 million unnecessary Cesarean Deliveries (CD) are performed globally. Such high unnecessary CD rate is a concern not only due to the additional financial burden it places on the health system, but also because the quality of care could be compromised. There is an even more imperative need to reduce elective surgeries in moving towards the Universal Health Coverage (UHC), to ensure the ever stretched resources are effectively channeled for the best health outcomes. Methods:The paper uses a case study method. China and Brazil were selected primarily due to their alarmingly high number and percentage of the CD rate. Systematic literature review was conducted and the analyses were structured based on the framework "Determinants of High Cesarean Delivery Rates", developed by the authors. Results:In China and Brazil, cultural belief, fear of labor pain and patient's perception regarding quality of care may play a role in the patient's preference for CD but these perceptions are shaped by their health care providers as well. The principal-agent relation comes into play as the health professionals can modify perceived needs of their patients. Availability of health insurance to mothers, physicians' preference for convenient working hours, and payment incentives for performing higher yielding Cesarean procedures are driving the high CD rate phenomena in China and Brazil.Understand the social determinants of CD and using various instruments to change women's perceptions of birthing options and physicians' behaviors are critical in managing the CD rate. Conclusion:In the context of the rapid movement towards UHC, the evidence presented in this paper supports the call for implementing complementary policy interventions and regulation to ensure minimal efficiency loss due to resources being diverted to unnecessary procedures or hospital stays.

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Section: Reforming Payment Mechanismsmentioning

confidence: 99%

Factors associated with high Cesarean deliveries in China and Brazil - A Call for reducing elective surgeries in moving towards Universal Health Coverage

Hou¹,

Rakhshani

Iunes³

2014

JHA

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“…Ein extrinsischer Faktor im Zusammenhang mit der erhöhten Zahl vaginal-operativer Eingriffe bei Geburten unter PDA wird mit dem "physician factor" bezeichnet. Dabei wird postuliert, dass das Vorgehen des Geburtshelfers prinzipiell durch die Realisierung einer Schmerzfreiheit durch eine PDA beeinflusst wird, wenngleich die Zahlen der Eingriffe mit den Zahlen der PDA nicht korrelieren [3,13,19]. Die Gründe für die Akzeptanz oder Ablehnung einer PDA sind sicherlich vielschichtig.…”

Section: Originalarbeit 23unclassified

Einfluss von Faktoren des sozioökonomischen Status auf die Anwendung der Periduralanästhesie subpartal

Morr

Broscheit²,

Blissing³

et al. 2007

Z Geburtshilfe Neonatol

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“…In one trial, at three years disability (as assessed by the expanded disability scale scoring system) had worsened less in aggregate in the cohort treated with high dose interferon beta than in the cohort treated with placebo. 4 The difference was significant. A favourable effect of interferon beta-1b on disability has been shown, albeit less convincingly than might have been wished.…”

Section: Current Policy Is Sensiblementioning

confidence: 89%

“…Interferon beta-1b was shown in the five year pivotal trial in relapsingremitting multiple sclerosis to reduce the rate of severe relapses by one half and the overall relapse rate by one third. 4 Studies have highlighted the fact that relapses can have a profound effect on the quality of life of people with multiple sclerosis and their carers (data on file). Additionally, patients who received interferon beta-1b in the pivotal trial showed no increase in total lesion load on magnetic resonance imaging over five years, compared with an increase of about 30% in the placebo group.…”

Section: Interferon Beta Reduces Overall Relapse Rate By One Thirdmentioning

confidence: 99%

Newly licensed drugs

Smeeth

Hippisley‐Cox²,

Paris³

et al. 1997

BMJ

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Decreasing the cesarean section rate in a private hospital: Success without mandated clinical changes

Cited by 79 publications

References 19 publications

Factors associated with high Cesarean deliveries in China and Brazil - A Call for reducing elective surgeries in moving towards Universal Health Coverage

Factors associated with high Cesarean deliveries in China and Brazil - A Call for reducing elective surgeries in moving towards Universal Health Coverage

Einfluss von Faktoren des sozioökonomischen Status auf die Anwendung der Periduralanästhesie subpartal

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