Promotion of Pre-natal Education Courses Is Associated With Reducing the Rates of Caesarean Section: A Case-Control Study

Tang, Yiqun; Gao, Jing; Sun, Liping; Gao, Yifei; Guo, Fang; Chen, Qi

doi:10.3389/fpubh.2021.666337

Cited by 1 publication

(9 citation statements)

References 26 publications

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“…The 133 included studies collectively reported on more than 9.1 million surgical procedures (median per study, 894 [IQR, 97-4259]) and more than 11.4 million participants (median per study, 989 [IQR, 257-6857]) from 63 LMICs . Of all 133 LMICs, we found studies from 15 of all 29 low-income countries (51.7%), 25 of all 50 lower-middle–income countries (50.0%), and 23 of all 55 upper-middle–income countries (41.8%) . Fourteen studies (10.5%) were multinational …”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies (10.5%) were multinational . Of the 119 studies (89.5%) originating from single countries, 69 (58.0%) were from upper-middle–income countries and 30 (25.2%) were from East Asia and the Pacific (Table 1 and Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…Most studies (115 [86.5%]) were published in 2010 or after, with a marked increase in the number of included studies per year. Most articles were written in English (126 [94.7%]) . Health care settings were hospital based or secondary care in 93 studies (69.9%) …”

Section: Resultsmentioning

confidence: 99%

“…Most articles were written in English (126 [94.7%]) . Health care settings were hospital based or secondary care in 93 studies (69.9%) . Of the 133 included studies, 107 (80.5%) were observational…”

Section: Resultsmentioning

confidence: 99%

“…Consequences of overuse of surgical procedures were reported in only 8 studies (6.0%). 49,50,54,96,138,142,151,154 The most frequently reported consequence was the economic burden.…”

Section: Consequencesmentioning

confidence: 99%

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Low-Value Surgical Procedures in Low- and Middle-Income Countries

Albarqouni,

Abukmail,

MohammedAli

et al. 2023

JAMA Netw Open

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ImportanceOveruse of surgical procedures is increasing around the world and harms both individuals and health care systems by using resources that could otherwise be allocated to addressing the underuse of effective health care interventions. In low- and middle-income countries (LMICs), there is some limited country-specific evidence showing that overuse of surgical procedures is increasing, at least for certain procedures.ObjectivesTo assess factors associated with, extent and consequences of, and potential solutions for low-value surgical procedures in LMICs.Evidence ReviewWe searched 4 electronic databases (PubMed, Embase, PsycINFO, and Global Index Medicus) for studies published from database inception until April 27, 2022, with no restrictions on date or language. A combination of MeSH terms and free-text words about the overuse of surgical procedures was used. Studies examining the problem of overuse of surgical procedures in LMICs were included and categorized by major focus: the extent of overuse, associated factors, consequences, and solutions.FindingsOf 4276 unique records identified, 133 studies across 63 countries were included, reporting on more than 9.1 million surgical procedures (median per study, 894 [IQR, 97-4259]) and with more than 11.4 million participants (median per study, 989 [IQR, 257-6857]). Fourteen studies (10.5%) were multinational. Of the 119 studies (89.5%) originating from single countries, 69 (58.0%) were from upper-middle–income countries and 30 (25.2%) were from East Asia and the Pacific. Of the 42 studies (31.6%) reporting extent of overuse of surgical procedures, most (36 [85.7%]) reported on unnecessary cesarean delivery, with estimated rates in LMICs ranging from 12% to 81%. Evidence on other surgical procedures was limited and included abdominal and percutaneous cardiovascular surgical procedures. Consequences of low-value surgical procedures included harms and costs, such as an estimated US $3.29 billion annual cost of unnecessary cesarean deliveries in China. Associated factors included private financing, and solutions included social media campaigns and multifaceted interventions such as audits, feedback, and reminders.Conclusions and RelevanceThis systematic review found growing evidence of overuse of surgical procedures in LMICs, which may generate significant harm and waste of limited resources; the majority of studies reporting overuse were about unnecessary cesarean delivery. Therefore, a better understanding of the problems in other surgical procedures and a robust evaluation of solutions are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Consequences of overuse of surgical procedures were reported in only 8 studies (6.0%). 49,50,54,96,138,142,151,154 The most frequently reported consequence was the economic burden.…”

Section: Consequencesmentioning

confidence: 99%

See 3 more Smart Citations