Factors on the Gap between Predicted Cesarean Section Rate and Real Cesarean Section Rate in Tertiary Hospitals

Yun Mi Kim; Se Young Kim

doi:10.4069/kjwhn.2012.18.3.200

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Kim and Kim: Factors on the Gap between Predicted Cesarean Section Rate and Real Cesarean Section Rate in Tertiary Hospitals

Original Article

Korean Journal of Women Health Nursing

Korean Journal of Women Health Nursing 2012; 18(3): 200-208.

Published online: 30 September 2012

DOI: https://doi.org/10.4069/kjwhn.2012.18.3.200

Factors on the Gap between Predicted Cesarean Section Rate and Real Cesarean Section Rate in Tertiary Hospitals

Yun Mi Kim, Se Young Kim

College of Nursing, Eulji University, Daejeon, Korea.

Corresponding author: Kim, Se Young. College of Nursing, Eulji University, 77, 771beon-gil, Gyeryong-ro, Jung-gu, Daejeon 301-746, Korea. Tel: +82-42-259-1718, Fax: +82-42-259-1709, sarakimk@eulji.ac.kr

Received 18 July 2012 Revised 21 August 2012 Accepted 15 September 2012

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was aimed to examine the gap between predicted cesarean section rate and real cesarean section rate and it's determining factors of 44 tertiary hospitals.

Method

This study is a cross-sectional analysis using the data of 25,623 deliveries in 2009 drawn from homepage of Health Insurance Review and Assessment Service. Data were analyzed with t-test, F-test, Scheffe? test, and logistic regression.

Result

There were statistically significant differences in the gap of cesarean section rate (more gap indicates higher quality of delivery) by grade of nurse staffing and delivery cases. Hospitals with nurse staffing grade 1 to 2 had more possibility to be classified into higher grade in quality of delivery (OR 5.67, 95% CI 1.07~30.08). Also hospitals with over 500 delivery cases had more possibility be classified into higher grade in quality of delivery (OR 4.92, 95% CI 1.14~21.23, respectively).

Conclusion

The finding suggests that grade of nurse staffing may influence the real cesarean section rate because nurses do a vital role to prevent unnecessary cesarean section. Further study is required to provide evidence that nurse staffing influence on patient outcome and cost-effectiveness in order to obtain adequate number of nursing staffs.

Keywords: Nursing staff, Cesarean section, Hospital

Figures and Tables

Table 1

General Characteristics of Data Set

Table 2

Difference between Predicted Cesarean Section Rate and Real Cesarean Section Rate

Table 3

Grade of Nursing Management and Level of Cesarean Section Quality in Tertiary Hospitals (N=44)

Table 4

Predictors for the Gap between Predicted Cesarean Section Rate and Real Cesarean Section Rate

OR=odds ratio; CI=confidence interval.

Summary Statement

▪ What is already known about this topic?

To decrease cesarean section rate, WHO recommends hospitals to deploy one nurse per mother for supportive care during delivery process. The Korean government has evaluated the quality of delivery based on the gap between predicted cesarean section rate and real cesarean section rate among superior hospitals.

▪ What this paper adds?

There were significant differences in the gap of Cesarean section rates among the grades of nurse staffing and delivery cases in hospitals. Hospitals with better grade of nurse staffing and over 500 delivery had more possibility to be classified into a higher grade in quality of delivery.

▪ Implications for practice, education and/or policy

The influence of nurse staffing may improve the quality of delivery because nurses do a vital role to prevent unnecessary cesarean section during the delivery process. Hospitals need to consider nurse staffing to enhance the quality of delivery.

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