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Predictors of obstetric intervention rates: case-mix, staffing levels and organisational factors of hospital of birth

Joyce, Rachel, Webb, R. and Peacock, Janet (2002) Predictors of obstetric intervention rates: case-mix, staffing levels and organisational factors of hospital of birth Journal of Obstetrics & Gynaecology, 22, (6), pp. 618-625. (doi:10.1080/0144361021000020385).

Record type: Article


We performed a cross-sectional study of all Thames maternity units, 1994-96, including 540,834 live and stillbirths. In contrast to recent media speculation, no association of caesarean section rates with midwifery staffing levels was found after adjustment for confounders. The only association with staffing was with levels of junior obstetric staffing, which could be a reflection of less experienced management of labour. Caesarean section rates were also associated positively with the levels of delivery beds, which could be a reflection of the closer monitoring of labour that may result from increased bed availability. Both caesarean section and instrumental vaginal delivery rates were associated with epidural rates, which was expected from the literature. Variations in epidural rates were mainly associated with variations in demographic case-mix, due possibly to patient demand. Demographic case-mix was also associated with instrumental vaginal deliveries but not the caesarean section rate

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Published date: 2002
Keywords: cross-sectional studies, organization & administration, humans, pregnancy, female, obstetrics and gynecology department, obstetrical, health, epidural, standards, hospital, public health, literature, delivery, demand, london, diagnosis-related groups, utilization, extraction, vaginal delivery, midwifery, manpower, analgesia, cesarean section, england, birth


Local EPrints ID: 61839
ISSN: 0144-3615
PURE UUID: 495939bb-7670-4b1e-9547-07fa1b9e99cc

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Date deposited: 10 Sep 2008
Last modified: 17 Jul 2017 14:21

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Author: Rachel Joyce
Author: R. Webb
Author: Janet Peacock

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