Do incentives, complexity and the demand for leisure explain caesarean-section deliveries?
Purpose – The purpose of this paper is to understand the determinants of quality in obstetric care and particularly why caesarean sections (CS) are experiencing unprecedented increases in developed societies. Design/methodology/approach – The paper exploits a population-based database containing records on the determinants of CS to study the effects of hospital complexity and private financing and controlling for clinical and social determinants. The data refer to the entire population deliveries data from year 2003 as collected by the Catalan Health Service (Conjunt Mínim de Base de Dades). This paper employs multivariate statistical analysis and it distinguishes between total, programmed and non-programmed deliveries. Findings – Privately financed hospitals and hospital complexity are significant determinants of the probability of a CS. Overall, the paper finds significant clinical variability between public and private hospitals. The significance of mother's age suggests that the delay in the motherhood is more likely to increase the probability of a CS in public hospital deliveries while it is not the case of private hospitals. It finds that demand for leisure and capacity explains CS in public hospitals but not in private hospitals. Practical implications – Quality of care is influenced by reimbursement mechanism along with provider complexity, which suggests that there is scope for improvement in providers pay per intervention. Originality/value – The nature of the data and methods.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 36 (2009)
Issue (Month): 9 (September)
|Contact details of provider:|| Web page: http://www.emeraldinsight.com|
|Order Information:|| Postal: Emerald Group Publishing, Howard House, Wagon Lane, Bingley, BD16 1WA, UK|
Web: http://www.emeraldinsight.com/ijse.htm Email:
When requesting a correction, please mention this item's handle: RePEc:eme:ijsepp:v:36:y:2009:i:9:p:906-915. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Virginia Chapman)
If references are entirely missing, you can add them using this form.