Hospital Cost and Utilization Project Research Note 4. Who Receives Cesareans: Patient and Hospital Characteristics

摘要

The use of cesarean procedures in obstetrical care rose from 5.5 percent of all deliveries in 1970 to 16.5 percent in 1980. Using the 1977 Hospital Cost and Utilization (HCUP) Hospital Sample, 300 hospitals were cross-classified according to whether each had a neonatal intensive care unit (NICU) and whether each had a medical school affiliation. For each of the four resulting groups the average proportion of deliveries by cesarean section was related to differences in the mother's age, race, and source of payment; medical complications of mother or fetus; and hospital characteristics. Even after age, race or source of payment are held constant, affiliated hospitals and hospitals with NICUs typically show higher cesarean section rates than comparison group hospitals. However, with regard to the various maternal and fetal complications, hospitals with NICUs or medical school affiliations may be either more or less likely than comparison group hospitals to choose the cesarean option, depending on the specific complication.