Purpose: This paper reports on a project funded by the AHRQ which seeks to determine causes of 1986-1996 changes in methods of obstetric delivery, distinguishing between changes in behavior (system parameters) and changes in variables (system independent variables). Data and Methods: Data consist of 20,000 merged vital records and hospital discharge data for New York State, for each of the years 1986 and 1996, plus hospital and physician characteristics. The data reflect maternal characteristics, complications of pregnancy and delivery, birth and infant characteristics, and utilization and cost information. We regress method of delivery on these variables; and use the results for a simulation, to determine the causes of the changes in c-sections. The 1996 variables are used with the 1986 parameters, to determine how many cesarean sections would have occurred in 1996 if 1986 behavior had been maintained, and what the cesarean section rate would have been. Learning objectives: Presenters will compare the result of the simulation with the actual 1996 values. At the conclusion of the session, the participant will be able to interpret the differences between hypothetical and actual number of cesarean sections as the additional (positive or negative) 1996 cesarean sections attributable to 1986-1996 behavior changes, and thus be able to distinguish changes in system behavior from changes in system independent variables. The results will provide a stronger basis for public policy in relation to c-sections and VBACs. Participants will be able to employ similar methodology in other settings.
Learning Objectives: At the conclusion of the session, the participant will be able to interpret the differences between hypothetical and actual number of cesarean sections as the additional (positive or negative) 1996 cesarean sections attributable to 1986-1996 behavior changes, and thus be able to distinguish changes in system behavior from changes in system independent variables. Participants will be able to employ similar methodology in other settings.
Keywords: Pregnancy, MCH Epidemiology
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.