Urbanization and the Likelihood of a Cesarean Section

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Taipei Medical University Institutional Repository > 管理學院 > 醫務管理學系暨研究所 > 期刊論文 > Item 987654321/2241

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题名:	Urbanization and the Likelihood of a Cesarean Section
作者:	林恆慶 Chen CS;Lin HC;Liu TC;Pfeiffer S
贡献者:	醫務管理學系
日期:	2008
上传时间:	2009-08-18 16:29:25 (UTC+8)
摘要:	OBJECTIVE: This study examines the association between the likelihood of cesarean section (CS) and the degree of urbanization in Taiwan, exploring possible explanations for the difference. STUDY DESIGN: The database used in this study was the Taiwan 2004 National Health Insurance Research Database. A total of 200,207 singleton deliveries fulfilled our criteria and were included in our study. The urbanization level of cities/towns where parturients resided at the time of delivery was stratified into seven categories. A multilevel logistic regression model was applied to examine the relative likelihood of CS by urbanization level after adjusting for parturient, physician and hospital characteristics. RESULTS: There was an upward trend in the CS rate with advancing urbanization level; the CS rates for urbanization level 1 (most urbanized) through 7 (least urbanized) were 33.7, 32.3, 30.4, 30.2 29.7, 29.5, and 28.6%, respectively. Compared with participants living at the highest urbanization level, the adjusted odds of a CS were 0.91 (95% CI=0.85-0.98, p=0.014), 0.84 (95% CI=0.78-0.91, p<0.001), 0.83 (95% CI=0.68-0.88, p<0.001), 0.79 (95% CI=0.72-0.86, p<0.001), and 0.70 (95% CI=0.62-0.80, p<0.001) times, respectively, for those living in cities/towns ranked from the third highest to the lowest levels of urbanization. CONCLUSIONS: We conclude that higher urbanization levels were associated with higher odds of CS. Highly urbanized communities could therefore be targeted for policy intervention aimed at reducing the unnecessary CS rate
關聯:	European Journal of Obstetrics & Gynecology and Reproductive Biology.
数据类型:	article
显示于类别:	[醫務管理學系暨研究所] 期刊論文

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