Kiwanuka A I, Moore W M
University of Manchester, UK.
Eur J Obstet Gynecol Reprod Biol. 1993 Jun;50(1):59-64. doi: 10.1016/0028-2243(93)90165-9.
The influence of audit and feedback on use of caesarean section was investigated in a geographically defined population. At the beginning of 1986 and throughout that year the three principal reasons for the increased use of caesarean section were drawn to the attention of the resident obstetricians in the hospital where 85% of the women resident in the health district gave birth. A repeat survey of the indications for caesarean section was conducted for 1986 births. Despite an increase in the number of women delivered in 1986 who had previously had two or more sections, the caesarean section rate fell from 15.9% in 1982 to 12.7% in 1986 (P < 0.005). Most of this decrease was due to a reduction in caesarean section for the three indications that were the main contributors to the increased rate between 1974 and 1982. The rate for the women who gave birth in the hospital whose resident obstetricians had been informed about the preceding audit was 12.2%, compared with 15.6%, for the women who gave birth in other hospitals. Audit and feedback of specific information, imparted in a non-directive way to resident obstetricians responsible for performing caesarean section, probably accounted for a more rational use of caesarean section.
在一个特定地理区域的人群中，研究了审核与反馈对剖宫产使用情况的影响。1986年初及当年全年，剖宫产使用增加的三个主要原因引起了该医院住院产科医生的注意，该医院接收了健康区85%的产妇分娩。针对1986年出生的产妇进行了剖宫产指征的重复调查。尽管1986年分娩的产妇中曾接受过两次或更多次剖宫产的人数有所增加，但剖宫产率从1982年的15.9%降至1986年的12.7%（P<0.005）。这种下降主要是由于1974年至1982年期间导致剖宫产率上升的三个主要指征的剖宫产数量减少。住院产科医生收到先前审核信息的医院中产妇的剖宫产率为12.2%，而在其他医院分娩的产妇剖宫产率为15.6%。以非指导性方式向负责实施剖宫产的住院产科医生提供特定信息的审核与反馈，可能促使了剖宫产的更合理使用。
