Yuda Michio
Graduate School of Economics and Management, Tohoku University, 27-1 Kawauchi, Aoba-Ward, Sendai, Miyagi, 9808576, Japan.
BMC Res Notes. 2018 Sep 3;11(1):633. doi: 10.1186/s13104-018-3746-2.
As in many other countries, the ratio of caesarean section (c-section) delivery to total births in Japan is rising steadily, while the total number of deliveries is decreasing. Although c-sections can effectively prevent maternal and perinatal mortality and morbidity when medically justified, it is uncertain how medically unnecessary c-sections affect the short-, middle-, and long-term postnatal effects on the mother and child. As there are no empirical studies on c-section choice for Japan, this study uses individual medical facility panel data from 1999 to 2014 to comprehensively examine the effects of recent public and social environment changes on c-section delivery choice.
The empirical results from our fixed effect model show that c-section delivery and its ratio are higher in public hospitals, in relatively large clinics, and in clinics opening on holidays. In addition, increases in the lump-sum birth allowance and the number of medical malpractice lawsuits also increase the number of c-section delivery.
与许多其他国家一样，日本剖宫产（剖腹产）分娩占总出生数的比例在稳步上升，而分娩总数却在下降。虽然剖腹产在医学上合理时可有效预防孕产妇和围产期死亡率及发病率，但尚不确定非医学必要的剖腹产如何影响母婴产后的短期、中期和长期影响。由于日本尚无关于剖腹产选择的实证研究，本研究使用1999年至2014年的个体医疗设施面板数据，全面考察近期公共和社会环境变化对剖腹产分娩选择的影响。
我们固定效应模型的实证结果表明，公立医院、规模相对较大的诊所及节假日营业的诊所中，剖腹产分娩及其比例更高。此外，一次性生育津贴的增加和医疗事故诉讼数量的增加也会增加剖腹产分娩的数量。
