Morris Theresa, McNamara Kelly, Morton Christine H
Department of Sociology, Texas A&M University, College Station, TX, USA.
Independent Scholar, Redwood City, CA, USA.
Birth. 2017 Dec;44(4):325-330. doi: 10.1111/birt.12299. Epub 2017 Jul 24.
Given the increasing proportion of United States hospitals that are for-profit, we examined whether women who give birth in for-profit hospitals are more likely to have cesareans than women who give birth in not-for-profit hospitals. We hypothesized that cesareans are more likely to occur in for-profit hospitals because of the organizational emphasis on short-term financial indicators, including payment of shareholder dividends.
We used logistic regression and difference of means tests to analyze data from the Listening to Mothers III survey of women who gave birth in the United States in 2011 and 2012.
Controlling for patient-level characteristics, we found that the odds of a woman's having a cesarean were two times higher in for-profit hospitals than in not-for-profit hospitals. We also found for-profit hospitals were significantly more likely to be members of multihospital systems and to have fewer full-time registered nurses and staff members per hospital bed.
This research suggests that women who give birth in for-profit hospitals are more likely to have cesareans than women who give birth in not-for-profit hospitals. This information is important to women when deciding where to give birth. Knowing which hospital characteristics are associated with a greater likelihood of cesarean is helpful since hospital cesarean rates may be difficult to find. These findings are also informative for obstetric professionals, who can implement improvement initiatives to decrease cesarean rates and improve the overall quality of care for childbearing women in the United States.
鉴于美国营利性医院的比例不断增加，我们研究了在营利性医院分娩的女性是否比在非营利性医院分娩的女性更有可能接受剖宫产。我们假设，由于组织对短期财务指标的重视，包括支付股东股息，剖宫产更有可能在营利性医院发生。
我们使用逻辑回归和均值差异检验来分析2011年和2012年在美国分娩的女性的“倾听母亲III”调查数据。
在控制患者层面特征后，我们发现营利性医院中女性接受剖宫产的几率是非营利性医院的两倍。我们还发现，营利性医院更有可能是多医院系统的成员，并且每张病床的全职注册护士和工作人员较少。
这项研究表明，在营利性医院分娩的女性比在非营利性医院分娩的女性更有可能接受剖宫产。这些信息对于女性决定在哪里分娩很重要。由于医院的剖宫产率可能难以获取，了解哪些医院特征与更高的剖宫产可能性相关是有帮助的。这些发现对于产科专业人员也具有参考价值，他们可以实施改进措施来降低剖宫产率，并提高美国生育妇女的整体护理质量。
