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生育率下降和剖宫产术的使用:来自台湾一项基于人群的研究证据。

Declining fertility and the use of cesarean delivery: evidence from a population-based study in Taiwan.

机构信息

Graduate Institute of Healthcare Administration, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan.

出版信息

Health Serv Res. 2010 Oct;45(5 Pt 1):1360-75. doi: 10.1111/j.1475-6773.2010.01125.x.

DOI:10.1111/j.1475-6773.2010.01125.x
PMID:20545781
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2965509/
Abstract

OBJECTIVE

To test the hypothesis that declining fertility would affect the number of cesarean sections (c-sections) on maternal demand, but not medically indicated c-sections.

DATA SOURCES

The 1996-2004 National Health Insurance Research Database in Taiwan for all singleton deliveries.

STUDY DESIGN

Retrospective population-based, longitudinal study. Estimation was performed using multinomial probit models.

PRINCIPAL FINDINGS

Results revealed that declining fertility had a significant positive effect on the probability of having a c-section on maternal request but not medically indicated c-section.

CONCLUSIONS

Our findings offer a precautionary note to countries experiencing a fertility decline. Policies to contain the rise of c-sections should understand the role of women's preferences, especially regarding cesarean deliveries on maternal request.

摘要

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Health Serv Res. 2010 Oct;45(5 Pt 1):1360-75. doi: 10.1111/j.1475-6773.2010.01125.x.
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本文引用的文献

1
Impact of Medicaid Expansion on Early Prenatal Care and Health Outcomes.医疗补助扩大对早期产前护理及健康结果的影响
Health Care Financ Rev. 1998 Spring;19(4):85-99.
2
Physician financial incentives and cesarean delivery: new conclusions from the healthcare cost and utilization project.医生的经济激励与剖宫产:医疗成本和利用项目的新结论
J Health Econ. 2009 Jan;28(1):244-50. doi: 10.1016/j.jhealeco.2008.09.005. Epub 2008 Oct 2.
3
Financial incentives do not always work: an example of cesarean sections in Taiwan.经济激励措施并非总能奏效:以台湾地区剖宫产为例。
Health Policy. 2008 Oct;88(1):121-9. doi: 10.1016/j.healthpol.2008.02.013. Epub 2008 Apr 23.
4
Does elective caesarean section increase utilization of postpartum maternal medical care?选择性剖宫产会增加产后产妇医疗护理的利用率吗?
Med Care. 2008 Apr;46(4):440-3. doi: 10.1097/MLR.0b013e31816493e9.
5
Increased risk of stroke in patients who undergo cesarean section delivery: a nationwide population-based study.剖宫产分娩患者中风风险增加:一项基于全国人口的研究。
Am J Obstet Gynecol. 2008 Apr;198(4):391.e1-7. doi: 10.1016/j.ajog.2007.10.789. Epub 2008 Feb 14.
6
Screening for inter-hospital differences in cesarean section rates in low-risk deliveries using administrative data: an initiative to improve the quality of care.利用行政数据筛查低风险分娩中剖宫产率的医院间差异:一项提高医疗质量的举措。
BMC Health Serv Res. 2008 Jan 4;8:3. doi: 10.1186/1472-6963-8-3.
7
Doctors' obstetric experience and Caesarean section (CS): does increasing delivery volume result in lower CS likelihood?医生的产科经验与剖宫产:分娩量增加会降低剖宫产可能性吗?
J Eval Clin Pract. 2007 Dec;13(6):954-7. doi: 10.1111/j.1365-2753.2006.00763.x.
8
Factors affecting Taiwanese women's choice of Cesarean section.影响台湾女性选择剖宫产的因素。
Soc Sci Med. 2008 Jan;66(1):201-9. doi: 10.1016/j.socscimed.2007.07.030. Epub 2007 Sep 14.
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Obstetrician gender and the likelihood of performing a maternal request for a cesarean delivery.产科医生的性别与产妇要求剖宫产的可能性
Eur J Obstet Gynecol Reprod Biol. 2008 Jan;136(1):46-52. doi: 10.1016/j.ejogrb.2007.02.007. Epub 2007 Mar 26.
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Int J Gynaecol Obstet. 2007 Jan;96(1):57-61. doi: 10.1016/j.ijgo.2006.09.011. Epub 2006 Dec 21.