Private health care coverage and increased risk of obstetric intervention
- Hdl Handle:
- http://hdl.handle.net/10147/311946
- Title:
- Private health care coverage and increased risk of obstetric intervention
- Authors:
- Citation:
- BMC Pregnancy and Childbirth. 2014 Jan 13;14(1):13
- Issue Date:
- 13-Jan-2014
- URI:
- http://dx.doi.org/10.1186/1471-2393-14-13; http://hdl.handle.net/10147/311946
- Abstract:
- Abstract Background When clinically indicated, common obstetric interventions can greatly improve maternal and neonatal outcomes. However, variation in intervention rates suggests that obstetric practice may not be solely driven by case criteria. Methods Differences in obstetric intervention rates by private and public status in Ireland were examined using nationally representative hospital discharge data. A retrospective cohort study was performed on childbirth hospitalisations occurring between 2005 and 2010. Multivariate logistic regression analysis with correction for the relative risk was conducted to determine the risk of obstetric intervention (caesarean delivery, operative vaginal delivery, induction of labour or episiotomy) by private or public status while adjusting for obstetric risk factors. Results 403,642 childbirth hospitalisations were reviewed; approximately one-third of maternities (30.2%) were booked privately. After controlling for relevant obstetric risk factors, women with private coverage were more likely to have an elective caesarean delivery (RR: 1.48; 95% CI: 1.45-1.51), an emergency caesarean delivery (RR: 1.13; 95% CI: 1.12-1.16) and an operative vaginal delivery (RR: 1.25; 95% CI: 1.22-1.27). Compared to women with public coverage who had a vaginal delivery, women with private coverage were 40% more likely to have an episiotomy (RR: 1.40; 95% CI: 1.38-1.43). Conclusions Irrespective of obstetric risk factors, women who opted for private maternity care were significantly more likely to have an obstetric intervention. To better understand both clinical and non-clinical dynamics, future studies of examining health care coverage status and obstetric intervention would ideally apply mixed-method techniques.
- Item Type:
- Article
- Language:
- en
- Keywords:
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Lutomski, Jennifer E | en_GB |
dc.contributor.author | Murphy, Michael | en_GB |
dc.contributor.author | Devane, Declan | en_GB |
dc.contributor.author | Meaney, Sarah | en_GB |
dc.contributor.author | Greene, Richard A | en_GB |
dc.date.accessioned | 2014-01-28T10:45:56Z | - |
dc.date.available | 2014-01-28T10:45:56Z | - |
dc.date.issued | 2014-01-13 | - |
dc.identifier.citation | BMC Pregnancy and Childbirth. 2014 Jan 13;14(1):13 | en_GB |
dc.identifier.uri | http://dx.doi.org/10.1186/1471-2393-14-13 | - |
dc.identifier.uri | http://hdl.handle.net/10147/311946 | - |
dc.description.abstract | Abstract Background When clinically indicated, common obstetric interventions can greatly improve maternal and neonatal outcomes. However, variation in intervention rates suggests that obstetric practice may not be solely driven by case criteria. Methods Differences in obstetric intervention rates by private and public status in Ireland were examined using nationally representative hospital discharge data. A retrospective cohort study was performed on childbirth hospitalisations occurring between 2005 and 2010. Multivariate logistic regression analysis with correction for the relative risk was conducted to determine the risk of obstetric intervention (caesarean delivery, operative vaginal delivery, induction of labour or episiotomy) by private or public status while adjusting for obstetric risk factors. Results 403,642 childbirth hospitalisations were reviewed; approximately one-third of maternities (30.2%) were booked privately. After controlling for relevant obstetric risk factors, women with private coverage were more likely to have an elective caesarean delivery (RR: 1.48; 95% CI: 1.45-1.51), an emergency caesarean delivery (RR: 1.13; 95% CI: 1.12-1.16) and an operative vaginal delivery (RR: 1.25; 95% CI: 1.22-1.27). Compared to women with public coverage who had a vaginal delivery, women with private coverage were 40% more likely to have an episiotomy (RR: 1.40; 95% CI: 1.38-1.43). Conclusions Irrespective of obstetric risk factors, women who opted for private maternity care were significantly more likely to have an obstetric intervention. To better understand both clinical and non-clinical dynamics, future studies of examining health care coverage status and obstetric intervention would ideally apply mixed-method techniques. | - |
dc.language.iso | en | en |
dc.subject | PREGNANCY | en_GB |
dc.subject | CHILDBIRTH | en_GB |
dc.subject | PRIVATE HEALTH CARE | en_GB |
dc.title | Private health care coverage and increased risk of obstetric intervention | en_GB |
dc.type | Article | en |
dc.language.rfc3066 | en | - |
dc.rights.holder | Jennifer E Lutomski et al.; licensee BioMed Central Ltd. | - |
dc.description.status | Peer Reviewed | - |
dc.date.updated | 2014-01-22T12:15:49Z | - |
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