In urban China, many non-clinically indicated cesarean sections (NCSs) are performed, resulting in an unnaturally high cesarean section (CS) rate. NCSs represent CSs without any specific medical indications. The demand for NCS may be due to women's preference for CS and their belief in its safety and comfortableness. In addition, CS is more profitable for the supply side than vaginal delivery, which results in a continued rise in delivery expenditures. As a result, the so-called "price transparency policy", which forces hospitals to declare their average hospital charges, was adopted to control the delivery expenditures in the ongoing Chinese healthcare reform policy. The purpose of this study is to prove that the supply and demand factors affect the choice of delivery modes and more resources are consumed in NCS. The data of 680 live deliveries were collected from three hospitals in Beijing. Multinomial logistic regression analyses were conducted to identify the factors related to choosing NCS, and ANOVA and ANCOVA were used to compare the charges, proxy for resource utilization, among the delivery modes or hospitals. The results showed that the high NCS rate (37.7%) might be predicted not only based on the demand factors (region of residence, parity, maternal age and weight gain) but also on the supply factors (hospital dummy, revenue-staff ratio, bed turnover rate and obstetric medical staffs-delivery ratio), suggesting that such induced NCSs result in an unnecessarily high resource consumption. These data suggest that the present Chinese policy fails to control delivery expenditures.China; choice of delivery modes; hospital charge; non-clinically indicated caesarean section (NCS); price transparency policy
The caesarean section (CS) rate and non-clinically-indicated CS (NCS) rate in urbanChina are extremely high. On the demand side the assumed reason is China's one-child policy. We also assume that the supply side induces the CS demand, thus resulting in a continued rise in delivery expenditure. Therefore, so-called 'price transparency policy' was adopted to control costs. This study aims to prove that demand and supply factors may cause the high NCS rate, thus affecting the consequences of this policy, and causing a waste of resources and increased delivery expenditure. We conducted a multinomial logistic regression analysis to identify factors related to the high NCS rate, ANOVA and ANCOVA to compare the resource waste among the different delivery modes or hospitals. It was confirmed that the high NCS rate (37.7 per cent) in urban China might be predicted based not only on the demand factors (region of residence, parity, maternal age and weight gain), but also supply factors (hospital dummy). The price transparency policy requiring providers to disclose hospital charges information has thus led to inaccurate average CS charges, which confuse consumers, thus contributing to the overuse of NCS. Our study indicates that this policy could not effectively control costs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.