Impact of risk-adjusting cesarean delivery rates when reporting hospital performance
Impact of risk-adjusting cesarean delivery rates when reporting hospital performance
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DOI：
10.1001/jama.279.24.1968
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发表时间：
1998-06-24
影响因子：
120.7
通讯作者：
Rosenthal, GE
中科院分区：
文献类型：
--
作者：
Aron, DC;Harper, DL;Rosenthal, GE
背景。-医院和健康计划通常根据剖宫产率进行排名，假设较低的比率反映了更合适，更有效的护理。然而，大多数排名没有考虑到影响剖宫产可能性的患者因素。比较调整增加剖宫产可能性的临床风险因素前后的医院剖宫产率。回顾性队列研究，背景。俄亥俄州东北部21家医院的病人从1993年1月至1995年6月，共有26127名无剖宫产史的妇女入院分娩。基于观察和风险调整的剖宫产率的医院排名。剖宫产率为15.9%，差异有统计学意义（P
Context.-Hospitals and health plans are often ranked on rates of cesarean delivery, under the assumption that lower rates reflect more appropriate, more efficient care. However, most rankings do not account for patient factors that affect the likelihood of cesarean delivery.Objective.-To compare hospital cesarean delivery rates before and after adjusting for clinical risk factors that increase the likelihood of cesarean delivery.Design.-Retrospective cohort study,Setting.-Twenty-one hospitals in northeast Ohio.Patients.-A total of 26 127 women without prior cesarean deliveries admitted for labor and delivery from January 1993 through June 1995.Main Outcome Measures.-Hospital rankings based on observed and risk-adjusted cesarean delivery rates.Results.-The overall cesarean delivery rate was 15.9% and varied (P