Obstetric anesthesia units in Israel: a national questionnaire-based survey

Weiniger, Carolyn F.; Ivri, S.; Ioscovich, Alexander; Grimberg, L; Evron, Shmuel; Ginosar, Yehuda

doi:10.1016/j.ijoa.2010.04.009

Cited by 23 publications

(32 citation statements)

References 17 publications

(20 reference statements)

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“…The methodology of these surveys has been previously described [4]. Briefly, a questionnaire was sent on two occasions to all directors of departments of anesthesia or the nominated directors of the obstetric anesthesia units or services in all Israeli hospitals providing labor and delivery services.…”

Section: Methodsmentioning

confidence: 99%

“…Twenty-five hospitals were surveyed in 2005. In 2007 there were an additional 2 hospitals providing independent obstetric anesthesia services [4]. In the current secondary analysis only data from the 25 hospitals participating in both surveys are presented.…”

Section: Methodsmentioning

confidence: 99%

“…Obstetric anesthesia workload in Israel has increased due to both an increase in the cesarean delivery rate (rising from 9.6% in 1992 [2] to 17–18% by 2004 [3]) and epidural labor analgesia. Laboring women may be disproportionately affected by the anesthesia workforce crisis, as labor analgesia may be perceived to be neither life-saving nor profitable [4]. …”

Section: Introductionmentioning

confidence: 99%

“…Recently we published a nationwide survey of all obstetric anesthesia unit directors in Israel [4] to assess workload demand and workforce supply in obstetric anesthesia. The number of deliveries per hospital per year is the traditional benchmark for maternity services activity, but this was not the only factor found to determine demands for obstetric anesthesia workload.…”

Section: Introductionmentioning

confidence: 99%

“…For this purpose, we developed a single composite denominator of obstetric anesthesia activity, the Obstetric Anesthesia Activity Index (OAAI), and performed a secondary analysis of data from our previous study [4] in order to assess its usefulness. We hypothesized that the OAAI would enable direct comparison of obstetric anesthesia workload demands of different hospitals despite dissimilar epidural and cesarean rates.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Comparison of the obstetric anesthesia activity index with total delivery numbers as a single denominator of workload demand in Israeli maternity units

Ginosar

Ioscovich

Weissman

et al. 2012

Isr J Health Policy Res

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BackgroundObstetric anesthesia workload demand in Israel has increased due to both an increase in the requests for labor analgesia and a marked increase in the cesarean delivery rate. We propose a new workload-driven performance indicator, the Obstetric Anesthesia Activity Index (OAAI), to serve as a single denominator of obstetric anesthesia activity to enable direct comparison of different hospitals despite dissimilar rates of epidural labor analgesia and cesarean delivery.MethodsWe performed a secondary analysis of two recent national surveys by the Israel Association of Obstetric Anesthesia. In 2005 and 2007 questionnaires were sent to all Israeli hospitals requesting information on the total numbers of deliveries, epidurals, and cesareans annually, together with the anesthesia workforce allocated for the provision of obstetric anesthesia services. The OAAI was calculated based on the premise that epidurals and cesareans are the predominant determinants of obstetric anesthesia workload and that a typical epidural takes about half the time of a typical cesarean. Accordingly, the OAAI for each hospital was calculated as ((0.75 * number of epidurals per year) + (1.5 * number of cesareans per year))/365.ResultsThis secondary analysis assessed the 25 maternity units in Israel that participated in both the 2005 and 2007 surveys. As expected, there was a wide inter-hospital variability in epidural and cesarean rates. Hospital rankings based on annual delivery numbers were different from those based on the OAAI. The OAAI correlated closely both with the number of epidurals (2005: Pearson 0.97, p < 0.0001; 2007: Pearson 0.97, p < 0.0001) and cesareans (2005: Pearson 0.94, p < 0.0001; 2007: Pearson 0.92, p < 0.0001). These correlations were better for the OAAI than for the annual delivery numbers.ConclusionsAs there was such a wide range of demand for different obstetric anesthesia services among different hospitals, the total number of deliveries is a poor summary indicator of obstetric anesthesia workload. The calculated OAAI better reflected the obstetric anesthesia workload as a single denominator of activity.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%