Milcent Carine, Zbiri Saad
Paris-Jourdan Sciences Economiques, French National Center for Scientific Research, Paris, France.
EA 7285, Versailles Saint Quentin University, Montigny-le-Bretonneux, France.
Health Econ Rev. 2018 Mar 10;8(1):7. doi: 10.1186/s13561-018-0190-x.
Cesarean deliveries are widely used in many high- and middle-income countries. This overuse both increases costs and lowers quality of care and is thus a major concern in the healthcare industry. The study first examines the impact of prenatal care utilization on cesarean delivery rates. It then determines whether socioeconomic status affects the use of prenatal care and thereby influences the cesarean delivery decision. Using exclusive French delivery data over the 2008-2014 period, with multilevel logit models, and controlling for relevant patient and hospital characteristics, we show that women who do not participate in prenatal education have an increased probability of a cesarean delivery compared to those who do. The study further indicates that attendance at prenatal education varies according to socioeconomic status. Low socioeconomic women are more likely to have cesarean deliveries and less likely to participate in prenatal education. This result emphasizes the importance of focusing on pregnancy health education, particularly for low-income women, as a potential way to limit unnecessary cesarean deliveries. Future studies would ideally investigate the effect of interventions promoting such as care participation on cesarean delivery rates.
剖宫产在许多高收入和中等收入国家被广泛使用。这种过度使用既增加了成本又降低了护理质量，因此是医疗行业的一个主要担忧。该研究首先考察了产前护理利用对剖宫产率的影响。然后确定社会经济地位是否会影响产前护理的使用，从而影响剖宫产决策。利用2008 - 2014年期间法国独有的分娩数据，采用多层次逻辑模型，并控制相关的患者和医院特征，我们发现，与参加产前教育的女性相比，未参加产前教育的女性剖宫产的概率更高。该研究进一步表明，产前教育的参与情况因社会经济地位而异。社会经济地位低的女性更有可能进行剖宫产，而参与产前教育的可能性较小。这一结果强调了关注孕期健康教育的重要性，特别是对于低收入女性，这是限制不必要剖宫产的一种潜在方式。理想情况下，未来的研究将调查促进护理参与等干预措施对剖宫产率的影响。
