The 131st Annual Meeting (November 15-19, 2003) of APHA

The 131st Annual Meeting (November 15-19, 2003) of APHA

3197.0: Monday, November 17, 2003 - Board 8

Abstract #72447

Refutation of the target income hypothesis: The case of Ontario cesarean rates

Vincent V. Richman, MBA PhD, School of Business and Economics, Sonoma State University, 1801 East Cotati Avenue, 2042 Stevenson Hall, Rohnert Park, CA 94928, 707 664-2377, VRichman@hotmail.com

One stream of economic literature proposes target income as a motivating factor that explains the increases in cesarean rates; physicians, in order to maintain their incomes, increased their rates of cesarean sections, when faced with decreasing numbers of births. Cesarean rates are a complex phenomenon, influenced by clinical, physician, hospital and insurance factors. This paper examines the case of increasing cesarean rates in the Canadian province of Ontario, during the period of 1983-1992 and provides an alternative explanation. This paper studies changes in the maternity unit cesarean rate among Ontario maternity units over the period of 1983-1992. This paper studies the association between changes in the number of maternity hospital beds and changes in the cesarean rate. The cesarean rate was more likely to decrease (increase) with either an increase (decrease) in admissions or a decrease (increase) in maternity beds. The existence of a nosocomial factor provides an alternative explanation for the phenomenon of increasing cesarean rates in the presence of decreasing births – hospitals tend to perform the same number of cesarean sections.

Learning Objectives:

Keywords: Economic Analysis, Health Care Delivery

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Poster Session 4

The 131st Annual Meeting (November 15-19, 2003) of APHA