Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Effect of Repeated Public Releases on Cesarean Section Rates

  • Jang, Won-Mo (Department of Health Policy and Management, Seoul National University College of Medicine) ;
  • Eun, Sang-Jun (Department of Preventive Medicine, Keimyoung University College of Medicine) ;
  • Lee, Chae-Eun (Institute of Health Policy and Management, Medical Research Center, Seoul National University) ;
  • Kim, Yoon (Department of Health Policy and Management, Seoul National University College of Medicine)
  • Received : 2010.07.26
  • Accepted : 2010.10.14
  • Published : 2011.01.31
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Abstract

Objectives: Public release of and feedback (here after public release) on institutional (clinics and hospitals) cesarean section rates has had the effect of reducing cesarean section rates. However, compared to the isolated intervention, there was scant evidence of the effect of repeated public releases (RPR) on cesarean section rates. The objectives of this study were to evaluate the effect of RPR for reducing cesarean section rates. Methods: From January 2003 to July 2007, the nationwide monthly institutional cesarean section rates data (1 951 303 deliveries at 1194 institutions) were analyzed. We used autoregressive integrated moving average (ARIMA) time-series intervention models to assess the effect of the RPR on cesarean section rates and ordinal logistic regression model to determine the characteristics of the change in cesarean section rates. Results: Among four RPR, we found that only the first one (August 29, 2005) decreased the cesarean section rate (by 0.81 percent) and continued to have an impact period through the last observation in May 2007. Baseline cesarean section rates (OR, 4.7; 95% CI, 3.1 to 7.1) and annual number of deliveries (OR, 2.8; 95% CI, 1.6 to 4.7) of institutions in the upper third of each category at before first intervention had a significant contribution to the decrease of cesarean section rates. Conclusions: We could not found the evidence that RPR has had the significant effect of reducing cesarean section rates. Institutions with upper baseline cesarean section rates and annual number of deliveries were more responsive to RPR.

Keywords

References

  1. OECD(Organization for Economic Co-operation and Development). Health at a glance 2009-OECD indicators. Organization for Economic Paris: OECD; 2009
  2. Health Insurance Review & Assessment Service. Report of national cesarean section rates. [cited 2009 Mar 16]. Available from: http://www.hira.or.kr/.
  3. Baicker K, Buckles KS, Chandra A. Geographic variation in the appropriate use of cesarean delivery. Health Aff (Millwood) 2006; 25(5): w355-w367. https://doi.org/10.1377/hlthaff.25.w355
  4. Librero J, Peiro S, Calderon SM. Inter-hospital variations in caesarean sections. A risk adjusted comparison in the Valencia public hospitals. J Epidemiol Community Health 2000; 54(8): 631-636. https://doi.org/10.1136/jech.54.8.631
  5. Chaillet N, Dumont A. Evidence-based strategies for reducing cesarean section rates: a meta-analysis. Birth 2007; 34(1): 53-64. https://doi.org/10.1111/j.1523-536X.2006.00146.x
  6. Althabe F, Belizan JM, Villar J, Alexander S, Bergel E, Ramos S, et al. Mandatory second opinion to reduce rates of unnecessary caesarean sections in Latin America: a cluster randomised controlled trial. Lancet 2004; 363(9425): 1934-1940. https://doi.org/10.1016/S0140-6736(04)16406-4
  7. Jamtvedt G, Young JM, Kristoffersen DT, Thomson O'Brien MA, Oxman AD. Audit and feedback: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2003; (3): CD000259.
  8. Walker R, Turnbull D, Wilkinson C. Strategies to address global cesarean section rates: a review of the evidence. Birth 2002; 29(1): 28-39. https://doi.org/10.1046/j.1523-536X.2002.00153.x
  9. Zwarenstein M, Reeves S, Barr H, Hammick M, Koppel I, Atkins J. Interprofessional education: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2001; (1): CD002213.
  10. Lansky D. Improving quality through public disclosure of performance information. Health Aff (Millwood) 2002; 21(4): 52-62. https://doi.org/10.1377/hlthaff.21.4.52
  11. Institute of Medicine. Medicare: a strategy for quality assurance. Washington, DC: National Academies; 1990.
  12. Kim CY, Ko SK, Kim KY. Are league tables controlling epidemic of caesarean sections in South Korea? BJOG 2005; 112(5): 607-611. https://doi.org/10.1111/j.1471-0528.2004.00481.x
  13. Rosenthal GE, Hammar PJ, Way LE, Shipley SA, Doner D, Wojtala B, et al. Using hospital performance data in quality improvement: the Cleveland Health Quality Choice experience. Jt Comm J Qual Improv 1998; 24(7): 347-360.
  14. Longo DR, Land G, Schramm W, Fraas J, Hoskins B, Howell V. Consumer reports in health care. Do they make a difference in patient care? JAMA 1997; 278(19): 1579-1584. https://doi.org/10.1001/jama.1997.03550190043042
  15. Mawson AR. Reducing cesarean delivery rates in managed care organizations. Am J Manag Care 2002; 8(8): 730-740.
  16. Iezzoni LI. Risk adjustment for measuring health care outcomes. Chicago, IL: Health Adminstration Press; 2003.
  17. Box GEP, Tiao GC. Intervention analysis with applications to economic and environmental problems. J Am Statist Assoc 1975; 70(349): 70-79. https://doi.org/10.1080/01621459.1975.10480264
  18. Wei WWS. Time series anaylsis: univariate and multivariate methods. Wesley: Pearson Addison Wesley, 2006.
  19. Shao YE. Multiple intervention analysis with application to sales promotion data. J Appl Stat 1997; 24(2): 181-192. https://doi.org/10.1080/02664769723792
  20. Enders W. Applied econometric time series. 2nd ed. Danver: Wiley; 2004.
  21. Abreu MN, Siqueira AL, Cardoso CS, Caiaffa WT. Ordinal logistic regression models: application in quality of life studies. Cad Saude Publica 2008; 24 (Suppl 4): S581- S591. https://doi.org/10.1590/S0102-311X2008001600010
  22. Fung CH, Lim YW, Mattke S, Damberg C, Shekelle PG. Systematic review: the evidence that publishing patient care performance data improves quality of care. Ann Intern Med 2008; 148(2): 111-123. https://doi.org/10.7326/0003-4819-148-2-200801150-00006
  23. Chosun Ilbo. Searched by cesarean section rates from January 1, 2005 to December 31, 2006. [cited 2010 Sep 27] Available from: http://www.chosun.com/.
  24. Berwick DM, James B, Coye MJ. Connections between quality measurement and improvement. Med Care 2003; 41(1 Suppl): 130-138.
  25. Khang YH, Yun SC, Jo MW, Lee MS, Lee SI. Public release of institutional Cesarean section rates in South Korea: which women were aware of the infromation? Health Policy 2008; 86(1): 10-16. https://doi.org/10.1016/j.healthpol.2007.09.012
  26. Marshall MN, Shekelle PG, Leatherman S, Brook RH. The public release of performance data: what do we expect to gain? A review of the evidence. JAMA 2000; 283(14): 1866-1874. https://doi.org/10.1001/jama.283.14.1866
  27. Schneider EC, Epstein AM. Influence of cardiac-surgery performance reports on referral practices and access to care. A survey of cardiovascular specialists. N Engl J Med 1996; 335(4): 251-256. https://doi.org/10.1056/NEJM199607253350406
  28. Hibbard JH, Harris-Kojetin L, Mullin P, Lubalin J, Garfinkel S. Increasing the impact of health plan report cards by addressing consumers' concerns. Health Aff (Millwood) 2000; 19(5): 138-143. https://doi.org/10.1377/hlthaff.19.5.138
  29. ibbard JH, Slovic P, Peters E, Finucane ML. Strategies for reporting health plan performance information to consumers: evidence from controlled studies. Health Serv Res 2002; 37(2): 291-313. https://doi.org/10.1111/1475-6773.024
  30. Hannan EL, Kumar D, Racz M, Siu AL, Chassin MR. New York State's Cardiac Surgery Reporting System: four years later. Ann Thorac Surg 1994; 58(6): 1852-1857 https://doi.org/10.1016/0003-4975(94)91726-4
  31. Peterson ED, DeLong ER, Jollis JG, Muhlbaier LH, Mark DB. The effects of New York's bypass surgery provider profiling on access to care and patient outcomes in the elderly. J Am Coll Cardiol 1998; 32(4): 993-999. https://doi.org/10.1016/S0735-1097(98)00332-5
  32. Hibbard JH, Stockard J, Tusler M. Hospital performance reports: impact on quality, market share, and reputation. Health Aff (Millwood) 2005; 24(4): 1150-1160. https://doi.org/10.1377/hlthaff.24.4.1150
  33. Hamblin R. Regulation, measurements and incentives. The experience in the US and UK: doeseos context matter? J R Soc Promot Health 2008; 128(6): 291-298. https://doi.org/10.1177/1466424008096617
  34. Lin HC, Xirasagar S. Institutional factors in cesarean delivery rates: policy and research implications. Obstet Gynecol 2004; 103(1): 128-136. https://doi.org/10.1097/01.AOG.0000102935.91389.53
  35. Tussing AD, Wojtowycz MA. The effect of physician characteristics on clinical behavior: cesarean section in New York State. Soc Sci Med 1993; 37(10): 1251-1260. https://doi.org/10.1016/0277-9536(93)90336-3
  36. Braveman P, Egerter S, Edmonston F, Verdon M. Racial/ethnic differences in the likelihood of cesarean delivery, California. Am J Public Health 1995; 85(5): 625-630. https://doi.org/10.2105/AJPH.85.5.625
  37. Graham WJ, Hundley V, McCheyne AL, Hall MH, Gurney E, Milne J. An investigation of women's involvement in the decision to deliver by caesarean section. Br J Obstet Gynaecol 1999; 106(3): 213-220. https://doi.org/10.1111/j.1471-0528.1999.tb08233.x

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