The use of quality control performance charts to analyze cesarean delivery rates nationally.
AuthorsTurner, Michael J
AffiliationUniversity College Dublin Centre for Human Reproduction, Coombe Women and Infants, University Hospital, Dublin, Ireland. firstname.lastname@example.org
MeSHCesarean Section/standards/*statistics & numerical data
Hospitals/statistics & numerical data
Quality Assurance, Health Care/*methods
*Quality Indicators, Health Care
MetadataShow full item record
CitationInt J Gynaecol Obstet. 2011 Jun;113(3):175-7. Epub 2011 Apr 11.
JournalInternational journal of gynaecology and obstetrics: the official organ of the, International Federation of Gynaecology and Obstetrics
AbstractOBJECTIVE: To examine the use of quality control performance charts to analyze cesarean rates nationally. METHODS: Information on cesarean rates was obtained for all 19 Irish maternity hospitals receiving state funding in 2009. All women who underwent cesarean delivery of a live or stillborn infant weighing 500 g or more between January 1 and December 31 were included. Deliveries were classified as elective or emergency. Individual hospitals were not identified in the analysis. RESULTS: The mean rates per hospital of elective and emergency cesarean were 12.9+/-2.6% (n=9337) and 13.8+/-3.0% (n=9989), respectively-giving an overall mean rate of 26.7+/-4.2% (n=19326) per hospital. Cesarean rates were normally distributed. Using a quality control performance chart with a cutoff 2 standard deviations from the mean, 1 hospital was above the normal range for both total and elective cesareans, indicating that its pre-labor obstetric practices warrant clinical review. Another hospital had a mean emergency cesarean rate above the normal range, indicating that its labor ward practices warrant review. CONCLUSION: Quality control performance charts can be used to analyze cesarean rates nationally and, thus, to identify hospitals at which obstetric practices should be reviewed.
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