University of Nevada Las Vegas School of Nursing Las Vegas NV.
Department of Biomedical Informatics Emory University School of Medicine Atlanta GA.
Nurs Open. 2020 Jan 4;7(2):627-633. doi: 10.1002/nop2.433. eCollection 2020 Mar.
The purpose of this study was to evaluate the variation in caesarean delivery rates across counties in Georgia and to determine whether county-level characteristics were associated with clusters.
This was a retrospective, observational study.
Rates of primary and repeat caesarean by maternal county of residence were calculated for 2008 through 2012. Global Moran's I (Spatial Autocorrelation) was used to identify geographic clustering. Characteristics of high and low-rate counties were compared using student's test and chi-squared test.
Spatial analysis of both primary and repeat caesarean rate identified the presence of clusters (Moran's I = 0.375; < .001). Counties in high-rate clusters had significantly lower access to midwives, more deliveries paid by Medicaid, higher proportion of births for women belonging to racial/ethnic minority groups and were more likely to be rural.
本研究旨在评估佐治亚州各县之间剖宫产率的变化，并确定县一级的特征是否与聚类有关。
这是一项回顾性、观察性研究。
计算了 2008 年至 2012 年产妇居住地的初产妇和重复剖宫产率。采用全局 Moran's I（空间自相关）来识别地理聚类。使用学生 t 检验和卡方检验比较高、低剖宫产率县的特征。
初产妇和重复剖宫产率的空间分析均显示存在聚类（Moran's I = 0.375；< 0.001）。高剖宫产率聚类的县中，获得助产士服务的机会明显较低，由医疗补助支付的分娩比例较高，属于少数族裔/族裔群体的产妇分娩比例较高，更有可能是农村地区。
