The cesarean decision in New York State, 1986. Economic and noneconomic aspects.
The cesarean decision in New York State, 1986. Economic and noneconomic aspects.
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1986 年纽约州的剖腹产决定。经济和非经济方面。
DOI：
10.1097/00005650-199206000-00006
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发表时间：
1992
期刊：
影响因子：
3
通讯作者：
Wojtowycz,MA
中科院分区：
文献类型：
--
作者：
Tussing,AD;Wojtowycz,MA
本研究描述了一个研究项目，涉及经济和非经济方面的剖宫产决定。这项研究是基于1986年的一组数据，涉及纽约州（不包括纽约市）的68,847例产科分娩，并且拥有已知用于分析剖宫产决定的最大数量的变量。作者估计了一个概率单位多元回归，其中因变量是分娩方式。这些结果与某些领域的普遍看法和研究结果不同，但在其他领域也引起了相当大的兴趣。与其他研究结果相反，作者没有发现医学院毕业日期与剖宫产概率之间的关系。更重要的是，作者没有找到太多支持产科医生进行剖腹产以从额外的费用收入中充实自己的想法。然而，我们的研究结果与产科医生偶尔进行剖腹产以管理他们的时间的想法是一致的，这确实代表了一种经济上的自我利益。这项研究开发了一个代理措施，担心医疗事故，并发现之间的负相关关系，担心医疗事故和剖宫产的使用。最后，县剖宫产率和调整后的医院剖宫产率强烈和显着影响的概率，一个给定的交付是剖宫产。
This study describes a research project involving economic and noneconomic aspects of the cesarean decision. The study was based on a 1986 data set dealing with 68,847 obstetric deliveries in New York State excluding New York City, and had the largest number of variables known to have been assembled to analyze the cesarean decision. The authors estimated a probit multiple regression in which the dependent variable was the method of delivery. The results diverge from widely held beliefs and research findings in some areas, and are of considerable interest in other areas. Contrary to other findings, the authors did not find a relationship between date of graduation from medical school and the probability of a cesarean section. More importantly, the authors failed to find much support for the idea that obstetricians perform cesareans to enrich themselves from the additional fee income. However, our findings are consistent with the idea that obstetricians occasionally perform cesarean sections to manage their time, which does represent a form of economic self-interest. The study developed a proxy measure for fear of malpractice and found a negative relationship between fear of malpractice and cesarean section use. Finally, county cesarean rate and adjusted hospital cesarean section rate strongly and significantly influenced the probability that a given delivery is performed by cesarean section.