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Eur J Obstet Gynecol Reprod Biol. 2007 May;132(1):27-34. Epub 2006 Jul 11.

Maternal request CS--role of hospital teaching status and for-profit ownership.

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1
Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.

Abstract

OBJECTIVE:

To examine whether hospitals' for-profit (FP) ownership and non-teaching status are associated with greater likelihood of maternal request cesarean (CS) relative to public and not-for-profit (NFP) and teaching status, respectively.

METHOD:

Retrospective, cross-sectional, population-based study of Taiwan's National Health Insurance claims data, covering all 739,531 vaginal delivery-eligible singleton deliveries during 1997-2000, using multiple logistic regression analyses.

RESULTS:

Adjusted for maternal age and geographic location, FP district hospitals (almost all non-teaching), followed by ob/gyn clinics were significantly more likely to perform request CS (OR=3.5-2.3) than public and NFP teaching hospitals. Among non-teaching and teaching hospitals, FPs were more likely to perform request CS than public and NFP hospitals (OR=2.3 and 2.5, respectively).

CONCLUSIONS:

Our findings are consistent with greater propensity of physicians in FP institutions to accommodate patient requests involving revenue-maximizing procedures such as request CS. This effect is moderated by teaching hospitals' preference for complicated cases, consistent with their teaching mission and hi-tech infrastructure.

PMID:
16837120
DOI:
10.1016/j.ejogrb.2006.05.022
[Indexed for MEDLINE]
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