Regional disparities in primary cesarean delivery rates in Japan: the role of obstetrician availability.

cesarean sections obstetric care quality obstetrician availability primary cesarean deliveries regional disparities

Journal

AJOG global reports
ISSN: 2666-5778
Titre abrégé: AJOG Glob Rep
Pays: United States
ID NLM: 101777907

Informations de publication

Date de publication:
Aug 2024
Historique:
medline: 6 8 2024
pubmed: 6 8 2024
entrez: 6 8 2024
Statut: epublish

Résumé

The prevalence of cesarean section procedures is on the rise worldwide, necessitating a deeper understanding of the factors driving this trend to mitigate potential adverse consequences associated with unnecessary cesarean section deliveries. This study aims to investigate the rate of primary cesarean deliveries (PCD), a potential key indicator of obstetric care quality. A national retrospective cohort study was conducted utilizing extensive data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan spanning the years 2012 to 2018. The study examined the temporal trends in PCD rates and the indications for these procedures across different prefectures. Additionally, the study employed the obstetrician disproportionality index, as published by the Ministry of Health, Labour, and Welfare, to assess the influence of obstetrician availability on PCD rates. Throughout the study period from 2012 to 2018, the rate of PCD in Japan remained relatively stable at approximately 14%. The primary indications for PCD in 2018 included labor arrest (18.3%), malpresentation (16.5%), nonreassuring fetal status (6.5%), and macrosomia (6.0%). Substantial regional disparities in PCD rates were observed, ranging from 8.9% to 20.4% among prefectures in 2018. Notably, prefectures categorized in the bottom 10 of the obstetrician disproportionality index exhibited significantly higher PCD rates compared to the top 10 prefectures ( Our study presents a comprehensive analysis of PCD rates in Japan, shedding light on regional disparities and highlighting the notable influence of obstetrician availability on clinical decision-making. This study contributes to the ongoing discourse on the escalating global trend in cesarean sections and the importance of healthcare resource allocation in maternal care.

Sections du résumé

Background UNASSIGNED
The prevalence of cesarean section procedures is on the rise worldwide, necessitating a deeper understanding of the factors driving this trend to mitigate potential adverse consequences associated with unnecessary cesarean section deliveries.
Objectives UNASSIGNED
This study aims to investigate the rate of primary cesarean deliveries (PCD), a potential key indicator of obstetric care quality.
Study Design UNASSIGNED
A national retrospective cohort study was conducted utilizing extensive data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan spanning the years 2012 to 2018. The study examined the temporal trends in PCD rates and the indications for these procedures across different prefectures. Additionally, the study employed the obstetrician disproportionality index, as published by the Ministry of Health, Labour, and Welfare, to assess the influence of obstetrician availability on PCD rates.
Results UNASSIGNED
Throughout the study period from 2012 to 2018, the rate of PCD in Japan remained relatively stable at approximately 14%. The primary indications for PCD in 2018 included labor arrest (18.3%), malpresentation (16.5%), nonreassuring fetal status (6.5%), and macrosomia (6.0%). Substantial regional disparities in PCD rates were observed, ranging from 8.9% to 20.4% among prefectures in 2018. Notably, prefectures categorized in the bottom 10 of the obstetrician disproportionality index exhibited significantly higher PCD rates compared to the top 10 prefectures (
Conclusions UNASSIGNED
Our study presents a comprehensive analysis of PCD rates in Japan, shedding light on regional disparities and highlighting the notable influence of obstetrician availability on clinical decision-making. This study contributes to the ongoing discourse on the escalating global trend in cesarean sections and the importance of healthcare resource allocation in maternal care.

Identifiants

DOI: 10.1016/j.xagr.2024.100366 PMID: 39104835 PMC: PMC11298634
pubmed: 39104835
doi: 10.1016/j.xagr.2024.100366
pii: S2666-5778(24)00060-1
pmc: PMC11298634
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100366

Informations de copyright

© 2024 The Authors.

Auteurs

Akihiko Ueda (A)

Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan (Ueda, Nakakita, Chigusa, Mogami, Mandai, and Kondoh).

Baku Nakakita (B)

Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan (Ueda, Nakakita, Chigusa, Mogami, Mandai, and Kondoh).

Yoshitsugu Chigusa (Y)

Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan (Ueda, Nakakita, Chigusa, Mogami, Mandai, and Kondoh).

Haruta Mogami (H)

Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan (Ueda, Nakakita, Chigusa, Mogami, Mandai, and Kondoh).

Genta Kato (G)

Solutions Center for Health Insurance Claims, Kyoto University Hospital, Kyoto, Japan (Kato).

Hiroaki Ueshima (H)

Center for Innovative Research and Education in Data Science, Institute for Liberal Arts and Sciences, Kyoto University, Kyoto, Japan (Ueshima).

Masaki Mandai (M)

Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan (Ueda, Nakakita, Chigusa, Mogami, Mandai, and Kondoh).

Eiji Kondoh (E)

Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan (Ueda, Nakakita, Chigusa, Mogami, Mandai, and Kondoh).
Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan (Kondoh).

Classifications MeSH