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.
Volume (Year): 36 (2009)
Issue (Month): 9 (July)
|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 you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.