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Cesarean delivery rate and staffing levels of the maternity unit

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  • Saad Zbiri
  • Patrick Rozenberg
  • François Goffinet
  • Carine Milcent

Abstract

Objective: To investigate whether staffing levels of maternity units affect prelabor urgent, elective, and intrapartum cesarean delivery rates. Methods: This population-based retrospective cohort study covers the deliveries of the 11 hospitals of a French perinatal network in 2008–2014 (N = 102 236). The independent variables were women’s demographic and medical characteristics as well as the type, organization, and staffing levels for obstetricians, anesthesiologists, and midwives of each maternity unit. Bivariate and multivariate analyses were conducted with multilevel logistic models. Results: Overall, 23.9% of the women had cesarean deliveries (2.4% urgent before labor, 10% elective, and 11.5% intrapartum). Independently of individual- and hospital-level factors, the level of obstetricians, measured by the number of full-time equivalent persons (i.e., 35 working hours per week) per 100 deliveries, was negatively associated with intrapartum cesarean delivery (adjusted odds ratio, aOR 0.55, 95% confidence interval, CI 0.36–0.83, P-value = 0.005), and the level of midwives negatively associated with elective cesarean delivery (aOR 0.79, 95% CI 0.69–0.90, P-value

Suggested Citation

  • Saad Zbiri & Patrick Rozenberg & François Goffinet & Carine Milcent, 2018. "Cesarean delivery rate and staffing levels of the maternity unit," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-14, November.
    • Handle: RePEc:plo:pone00:0207379
    DOI: 10.1371/journal.pone.0207379
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    References listed on IDEAS

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    1. Clark, Andrew E. & Milcent, Carine, 2011. "Public employment and political pressure: The case of French hospitals," Journal of Health Economics, Elsevier, vol. 30(5), pages 1103-1112.
    2. Carine Milcent & Saad Zbiri, 2018. "Prenatal care and socioeconomic status: effect on cesarean delivery," Health Economics Review, Springer, vol. 8(1), pages 1-21, December.
    3. repec:hal:wpaper:halshs-01724086 is not listed on IDEAS
    4. Grant, Darren, 2009. "Physician financial incentives and cesarean delivery: New conclusions from the healthcare cost and utilization project," Journal of Health Economics, Elsevier, vol. 28(1), pages 244-250, January.
    5. repec:hal:journl:halshs-01785750 is not listed on IDEAS
    6. repec:hal:psewpa:halshs-01724086 is not listed on IDEAS
    7. repec:hal:pseptp:halshs-01785750 is not listed on IDEAS
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    1. Saad Zbiri & Patrick Rozenberg & Carine Milcent, 2024. "Staff Resources in Public and Private Hospitals and Their Implication for Medical Practice: A French Study of Caesareans," Post-Print hal-04626835, HAL.
    2. Carine Milcent & Saad Zbiri, 2022. "Supplementary private health insurance: The impact of physician financial incentives on medical practice," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 57-72, January.

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