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Variation in cesarean section rates in Sweden - Causes and economic consequences

Author

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  • Eckerlund, Ingemar

    (Centre for Health Economics)

  • Gerdtham, Ulf-G

    (Centre of Health Economics)

Abstract

The average cesarean section rate in Sweden more than doubled during the 1970s, and amounted to 12-3 percent in 1983. After that, there was a steady-state for a couple of years and towards the end of the 80s even a small decrease, to 10.9 percent in 1990. In the early 90s, there was a slight tendency towards an increase. Continuously, however, there has been a considerable variation in cesarean section rates among obstetrical departments. The objective of the study was to explain the interdepartmental variation, and to discuss its potential economic consequences. Using data fron The Swedish Medical Birth Registry 1991, we made a cross-sectional study of the cesarean section rate at the departmental level. We identified some 20 determinants, demand- related as well as supply-related, including practice style. A general model including all regressors was specified. After reducing this model, we were able to explain about one third of the variation. We conclude that the large variation in cesarean section rates implies inefficiency, mainly due to overutilization, but perhaps also underutilization. It is difficult to calculate the resulting welfare loss to society, but we made some rough estimations, indicating an additional cost for "unnecessary" cesarean sections of 12-14 million SEK per year.

Suggested Citation

  • Eckerlund, Ingemar & Gerdtham, Ulf-G, 1996. "Variation in cesarean section rates in Sweden - Causes and economic consequences," SSE/EFI Working Paper Series in Economics and Finance 106, Stockholm School of Economics.
    • Handle: RePEc:hhs:hastef:0106
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    References listed on IDEAS

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    Cited by:

    1. Leonel Muinelo & Máximo Rossi & Patricia Triunfo, 2005. "Comportamiento médico: una aplicación a las cesáreas en el Uruguay," Documentos de Trabajo (working papers) 0605, Department of Economics - dECON.
    2. Alejandro Arrieta & Ariadna García-Prado, 2012. "Non-elective cesarean sections in public hospitals: hospital capacity constraints and doctor´s incentives," Documentos de Trabajo - Lan Gaiak Departamento de Economía - Universidad Pública de Navarra 1212, Departamento de Economía - Universidad Pública de Navarra.
    3. Alejandro Arrieta & Ariadna García Prado, 2016. "Non-elective C-sections in public hospitals: capacity constraints and doctor incentives," Applied Economics, Taylor & Francis Journals, vol. 48(49), pages 4719-4731, October.
    4. Patricia Triunfo & Máximo Rossi, 2009. "The effect of physicians’ remuneration system on the Caesarean section rate: the Uruguayan case," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 333-345, December.

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    More about this item

    Keywords

    Cesarean section; practice variation; economic consequences; regression analysis;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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