The use of quality control performance charts to analyze cesarean delivery rates nationally

Turner, Michael J.

doi:10.1016/j.ijgo.2011.01.012

Cited by 13 publications

(13 citation statements)

References 20 publications

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“…et al, [ 36 ] √ √ √ √ √ √ √ Roosmalen J. et al, [ 37 ] √ √ √ √ √ Rudman A et al, [ 38 ] √ √ √ Sawyer A. et al, [ 39 ] √(9 tools) √ Sheridan M. et al, [ 11 ] √ √ √ √ √ √ Sibanda T. et al, [ 19 ] √ √ √ Tucker J. et al, [ 40 ] √ √ √ √ Turner M. J. [ 41 ] √ √ Voerman G. £ et al, [ 42 ] √ √ √ √ √ √ √ √ <...>…”

Section: Resultsmentioning

confidence: 99%

“…One source highlighted the importance of measuring the CR rates of particular institutions and comparing these with the ‘normal’ range of elective and emergency caesareans; hospitals found to be above the normal range might need to review pre-labour obstetric practices, for example. Approaches were identified in some sources whereby CRs were disaggregated in relation to a core indicator of total CR, such as rates of caesarean section before/after onset of labour [ 52 ] and proportions of elective and emergency caesarean section [ 53 ] providing more meaningful information about the performance of the system, including decisions associated with the use of caesarean section and their outcomes. Since the initial review was conducted a new approach has emerged from the World Health Organisation (WHO) to measure CR at hospital level, based on Robson classification [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

“…Only two of the seven tools identified attempted to directly address this problem, however. In one tool a homogenous group of ‘standard primaparae’ (a typology of low-risk women) was defined in order for indicators in relation to these users to be compared across sites; in another the examination of CR rates both before and during labour included a disaggregated sub-sample of low-risk women to enhance understanding of this measurement [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

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Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators

Escuriet

White

Beeckman

et al. 2015

BMC Health Serv Res

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BackgroundThis paper critically reviews published tools and indicators currently used to measure maternity care performance within Europe, focusing particularly on whether and how current approaches enable systematic appraisal of processes of minimal (or non-) intervention in support of physiological or “normal birth”. The work formed part of COST Actions IS0907: “Childbirth Cultures, Concerns, and Consequences: Creating a dynamic EU framework for optimal maternity care” (2011-2014) and IS1405: Building Intrapartum Research Through Health - an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH) (2014-). The Actions included the sharing of country experiences with the aim of promoting salutogenic approaches to maternity care.MethodsA structured literature search was conducted of material published between 2005 and 2013, incorporating research databases, published documents in english in peer-reviewed international journals and indicator databases which measured aspects of health care at a national and pan-national level. Given its emergence from two COST Actions the work, inevitably, focused on Europe, but findings may be relevant to other countries and regions.ResultsA total of 388 indicators were identified, as well as seven tools specifically designed for capturing aspects of maternity care. Intrapartum care was the most frequently measured feature, through the application of process and outcome indicators. Postnatal and neonatal care of mother and baby were the least appraised areas. An over-riding focus on the quantification of technical intervention and adverse or undesirable outcomes was identified. Vaginal birth (no instruments) was occasionally cited as an indicator; besides this measurement few of the 388 indicators were found to be assessing non-intervention or “good” or positive outcomes more generally.ConclusionsThe tools and indicators identified largely enable measurement of technical interventions and undesirable health (or pathological medical) outcomes. A physiological birth generally necessitates few, or no, interventions, yet most of the indicators presently applied fail to capture (a) this phenomenon, and (b) the relationship between different forms and processes of care, mode of birth and good or positive outcomes. A need was identified for indicators which capture non-intervention, reflecting the reality that most births are low-risk, requiring few, if any, technical medical procedures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1151-2) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators

Escuriet

White

Beeckman

et al. 2015

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…This is extremely high compared to other settings, such as Bangladesh, where elective cesarean sections were reported to be 30% of all cesarean sections 24. In Dublin, Ireland, the proportion of elective cesarean sections between January 1 and December 31, 2009, was also less than 50% in relation to emergency operations 25. Requests for cesarean section have been observed more commonly in private clinics 26.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy outcomes associated with Cesarean deliveries in Peruvian public health facilities

Gonzales¹,

Tapia²,

Fort³

et al. 2013

IJWH

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A continuous rise in the rate of cesarean deliveries has been reported in many countries over recent decades. This trend has prompted the emergence of a debate on the risks and benefits associated with cesarean section. The present study was designed to estimate cesarean section rates over time during the period between 2000 and 2010 in Peru and to present outcomes for each mode of delivery. This is a secondary analysis of a large database obtained from the Perinatal Information System, which includes 570,997 pregnant women and their babies from 43 Peruvian public health facilities in three geographical regions: coast, highlands, and jungle. Over 10 years, 558,901 women delivered 563,668 infants weighing at least 500 g. The cesarean section rate increased from 25.5% in 2000 to 29.9% in 2010 (26.9% average; P < 0.01). The rate of stillbirths was lower with cesarean than vaginal deliveries (P < 0.01). On the other hand, and as expected, the rates for preterm births, twin pregnancies, and preeclampsia were higher in women who delivered by cesarean section (P < 0.01). More importantly, the rate of maternal mortality was 5.5 times higher in the cesarean section group than in the vaginal delivery group. Data suggest that cesarean sections are associated with adverse pregnancy outcomes.

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“…Th e use, however, of convenience recruitment meant that maternal height and weight were measured prospectively in the 1st trimester and thus, BMI was accurately calculated (Turner 2011). Most studies on maternal obesity and CS are based on self-reporting of weight and height, which has been shown to be inaccurate, particularly for BMI categorisation (Turner 2011;Fattah et al 2009). In addition, convenience recruitment aff orded the opportunity to measure maternal body composition directly using advanced BIA (Fattah et al 2010.…”

Section: Discussionmentioning

confidence: 99%

International variation in caesarean section rates and maternal obesity

O’Dwyer

Layte

O’Connor

et al. 2013

Journal of Obstetrics and Gynaecology

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The use of quality control performance charts to analyze cesarean delivery rates nationally

Abstract: Quality control performance charts can be used to analyze cesarean rates nationally and, thus, to identify hospitals at which obstetric practices should be reviewed.

Cited by 13 publications

References 20 publications

Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators

Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators

Pregnancy outcomes associated with Cesarean deliveries in Peruvian public health facilities

International variation in caesarean section rates and maternal obesity

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