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Econometric analysis of variation in cesarean section rates : A cross- sectional study of 59 obstetrical departments in Sweden

Eckerlund, Ingemar and Gerdtham, Ulf G. LU orcid (1998) In International Journal of Technology Assessment in Health Care 14(4). p.774-787
Abstract

The objective of this study was to explain the variation in cesarean section rates among hospitals (obstetrical departments) in Sweden, and to discuss its potential economic consequences. Using data from The Swedish Medical Birth Registry 1991, we made a cross-sectional study of the cesarean section rate at the departmental level. We identified some 20 determinants, demand-related as well as supply-related. A general model including all these regressors was species. After reducing this model, we were able to explain about one-quarter of the variation. We conclude that the large variation in cesarean section rates indicates inefficiency, due mainly to overutilization, but perhaps also underutilization. It is difficult to calculate the... (More)

The objective of this study was to explain the variation in cesarean section rates among hospitals (obstetrical departments) in Sweden, and to discuss its potential economic consequences. Using data from The Swedish Medical Birth Registry 1991, we made a cross-sectional study of the cesarean section rate at the departmental level. We identified some 20 determinants, demand-related as well as supply-related. A general model including all these regressors was species. After reducing this model, we were able to explain about one-quarter of the variation. We conclude that the large variation in cesarean section rates indicates inefficiency, due mainly to overutilization, but perhaps also underutilization. It is difficult to calculate the economic consequences or the welfare loss to society. We estimated an additional cost for unnecessary cesarean sections of 13-16 million Swedish crowns (SEK) per year.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cesarean Section, Economics, Practice Patterns, Regression Analysis
in
International Journal of Technology Assessment in Health Care
volume
14
issue
4
pages
14 pages
publisher
Cambridge University Press
external identifiers
  • scopus:0032430355
ISSN
0266-4623
DOI
10.1017/S0266462300012071
language
English
LU publication?
no
id
6ddc330d-7369-4152-afa1-5e867b9a42c3
date added to LUP
2018-10-09 12:29:32
date last changed
2022-01-31 05:58:17
@article{6ddc330d-7369-4152-afa1-5e867b9a42c3,
  abstract     = {{<p>The objective of this study was to explain the variation in cesarean section rates among hospitals (obstetrical departments) in Sweden, and to discuss its potential economic consequences. Using data from The Swedish Medical Birth Registry 1991, we made a cross-sectional study of the cesarean section rate at the departmental level. We identified some 20 determinants, demand-related as well as supply-related. A general model including all these regressors was species. After reducing this model, we were able to explain about one-quarter of the variation. We conclude that the large variation in cesarean section rates indicates inefficiency, due mainly to overutilization, but perhaps also underutilization. It is difficult to calculate the economic consequences or the welfare loss to society. We estimated an additional cost for unnecessary cesarean sections of 13-16 million Swedish crowns (SEK) per year.</p>}},
  author       = {{Eckerlund, Ingemar and Gerdtham, Ulf G.}},
  issn         = {{0266-4623}},
  keywords     = {{Cesarean Section; Economics; Practice Patterns; Regression Analysis}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{4}},
  pages        = {{774--787}},
  publisher    = {{Cambridge University Press}},
  series       = {{International Journal of Technology Assessment in Health Care}},
  title        = {{Econometric analysis of variation in cesarean section rates : A cross- sectional study of 59 obstetrical departments in Sweden}},
  url          = {{http://dx.doi.org/10.1017/S0266462300012071}},
  doi          = {{10.1017/S0266462300012071}},
  volume       = {{14}},
  year         = {{1998}},
}