Provider's Behavior Change after the Public Release of the Information on the Cesarean Section Rate

제왕절개 분만율 공표 후 요양기관의 분만행태 변화

  • 고수경 (국민건강보험공단 사회보장연구센터) ;
  • 신순애 (국민건강보험공단 사회보장연구센터) ;
  • 김기영 (국민건강보험공단 사회보장연구센터) ;
  • 김창엽 (서울대학교 의과대학 의료관리학교실)
  • Published : 2001.09.01

Abstract

This study was conducted to investigate provider's behavior change after releasing the information on the Cesarean section rate. Claims data filed at the National Health Insurance Corporation was used for this analysis and the focus of this study was the change of cesarean rate after the public disclosure of information. Average rates of the year 1999 and 2000 were compared, on the institutional basis, and range and coefficient of variation were estimated. For the last decade, Cesarean section rate has been increased dramatically. Clinical or demographic factors could not adequately explain the increase. Instead, nonclinical factors, such as financial incentive, physician's convenience, practice characteristics, etc., were more significant in explaining the increasing rate. Providers' behavior was significantly affected by the public release of information: after the release, average rate was decreased by 10.2%, and variations were also decreased. In particular, the extent of decrease was explained mainly by nonclinical factor rather than clinical ones. The results suggest that disseminating practice information to providers and consumers could contribute to reducing unnecessary medical service.

Keywords

References

  1. 2000년 제왕절개 분만실태 국민건강보험공단
  2. 보건학논집 v.36 no.1 정보의 실패와 보건의료정책 권순만
  3. 보건경제연구 v.5 no.1 의료수가규제의 파급효과에 대한 비교정태분석;정상분만과 제왕절개 김진현
  4. 예방의학회지 v.25 no.3 제왕절개율의 지역간 변이와 관련요인에 대한 연구 김혜경;이정운;박강원;문옥륜
  5. 데일리메디 홈페이지 한국여성 정상분만 선호 데일리메디
  6. 보건행정학회지 v.1 no.1 제왕절개율의 지역간 변이에 영향을 미치는 의료기관 특성요인 분석 안형식;권영대;이영성;김명기;김용익;신영수
  7. 예방의학회지 v.26 no.3 편도적출술 및 아데노이드제거술과 충수절제술의 지역별 변이 이홍기;문옥륜;이기효
  8. 정책분석의 정치경제 전상경
  9. 예방의학회지 v.31 no.4 임산부의 분만방법 결정과정과 만족도 전혜리;박정한;박순우;허창규;황순규
  10. 조선일보 홈페이지 내일병원폐업 수술취소 잇따라 조선일보
  11. 보건행정학회지 v.1 no.1 소규모 지역간 의료이용의 차이에 관한 문헌고찰 조우현;김한중
  12. 의사의 일반적 특성이 제왕절개 분만율에 미치는 영향에 관한 연구 조은희
  13. 한국여성민우회 세미나 한국의 출산의료화의 현실;여성.산모.환자로서의 출산경험을 중심으로 하정옥
  14. 위험한 탄생 한겨레 21
  15. Medical Care v.33 no.4 The effects of physician factors on the cesarean section decision Burns LR;Geller SE;Wholey DR
  16. American Journal of Public Health v.85 no.5 Racial/Ethnic difference in the likelihood of cesarean delivery,California Braveman P;Egerter S;Edmonston F;Verdon M
  17. American Journal of Public Health v.88 no.5 Increased cesarean section rated and emerging patterns of health insurance in Shanghai, China Cai W;Marks J;Chen C;Zhuang Y;Morris L;Harris J
  18. Takemi program in international health Cesarean sections in Mexican metropolitan areas;Why are the rates high? Cardense R.
  19. Health Policy v.35 The ambiruous relationship between practice variation and appropriateness of care;an agenda for further research Casparie AF
  20. Halth Service Research v.28 Effects of the relative fee structure on the use of surgical operations Escarce JJ
  21. Soc. Sic. Med v.37 no.10 Cesarean section in Britain and the United States 12% or 24%;is either the right rare? Francome C;Savage W
  22. Am. J. Obstes. Gynecol v.156 no.2 Temporal variation in rates of cesarean section for dystocia;does convenience play a role? Fraser W;Usher R;Mclean F;Bossenberry C;Thomson M;Kramer M;Smith L;Power H
  23. Rand Journal of Economics v.27 physician finansial incentive and cesarean section delivery Gruber J;Owings M
  24. Journal of Health Economics v.18 physician fdd and procedure intensity;the case of cesarean delivery Gruber J;Kim J;Mayzlin D
  25. Agency for Health Care policy and Research Variation in the use of cesarean sections Heilbrunn JZ;Park RE
  26. Journal of Epidemiology and Community Health v.48 What is the optimal cesarean section rate?;an outcome based study of existing variation Joffe M;Chapple J;Patercon C;Beard R
  27. Health Srvice Research v.32 no.4 Adjusting cesarean delivery rates for case mix Keeler EB;Park R;Bell R;Gifford D;Keesey J
  28. JAMA v.272 no.7 Socioeconomic factors and the odds of vaginal birth cesarean dellivery King DE;Lahiri K
  29. Journal of Health Economics v.18 A re-examination of the meaning and importance of supplier-induced demand Labelle R;Stoddart G;Rice T
  30. Preventive Medecine v.25 Cesaean section rates by type of maternal unit and livel of obstetric care;an area-based study in central Italy Lallo D;Perucci C;Bertollini R;Mallone S
  31. JAMA v.283 no.14 The public release of performance data Marchall MN
  32. The Journal of Reproductive Medicine v.34 no.6 Ractors associated with hospital-specific cesarean birth rates Newton ER;Higgins CS
  33. Am. J. Obstet. Gynecol v.170 no.2 Cesarean section delivery in the 1980s;International comparison by indication Notzon FC;Cnattingius S;Bergsjo P;Cole S;Taffel S;Irgens L;Daltveit A
  34. Am. J. Obstet. Gynecol v.172 no.6 Cesaean birth;How tp reduce the rate Paul RH;Miller DA
  35. Journal of Economic Perspective v.6 no.3 Diffusion of information in medical care Phelps C
  36. American Journal of Public Health v.84 no.1 Cesarean section and operative vaginal delivery in low-risk primiparous women, Western Australia Read AW;Prendiville W;Dawes V;Stanley F
  37. Health Policy v.55 Ethnical dilemmas in communicating medical information to the public Resnik DB
  38. Soc. Sci. Med v.37 no.10 Medically unnecessary cesarean section births;introduction to a symposium Sakala C
  39. Soc. Sci. Med v.37 no.10 Cesarean section;Medecal benefits and costs Shearer EL
  40. American Journal of Public Health v.80 no.3 Cesarean section use and source of payment;an analysis of California hospital discharge abstracts Stafford RS
  41. JAMA v.265 no.5 Alternative strategies for controlling rising cesarean section rate Stafford RS
  42. JAMA v.265 no.1 The impact of nonclinical factors on repeaat cesarean section Stafford RS
  43. Health Service Research v.29 no.1 Health Maintenance Organizations, Independent Practice Associations, and cesarean section rates Tussing AD;Wojtowycz MA