Overcoming the Shortcomings of Cesarean Section Rate as a Performance Indicator
Research Question: Is the Normal Uncomplicated Delivery (NUD) rate, in conjunction with the Adverse Delivery (AD) rate a reliable measure of the appropriateness of cesarean section use?
1. Report descriptive statistics (range, mean, median) for NUD and AD rates among obstetricians in British Columbia;
2. Compare rates of NUD and AD among groups of obstetricians stratified by quintile of CS rate;
3. Compare rates of NUD and AD among hospitals stratified by number of births per year;
4. Examine the association of NUD/AD as an exposure variable and CS rate as an outcome variable for the Province and within hospitals stratified on births per year.
1. Rates of Adverse Delivery Outcomes will be highest among obstetricians in the highest quintile of CS rate;
2. Rates of Adverse Delivery Outcomes will not differ by hospitals stratified by number of births per year;
3. NUD/AD will have a statistically significant correlation with CS among births in British Columbia.