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Econometric Analysis of Variation in Cesarean Section Rates: A Cross-sectional Study of 59 Obstetrical Departments in Sweden

Published online by Cambridge University Press:  10 March 2009

Ingemar Eckerlund  and
Ulf-G Gerdtham
Ingemar Eckerlund
Affiliation:
Stockholm School of Economics and The National Board of Health and Welfare
Ulf-G Gerdtham
Affiliation:
Stockholm School of Economics
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Abstract

The objective of this study was to explain the variation in cesarean section rates among hospitals (obstetrical departments) in Sweden, and to discuss its potential economic consequences. Using data from The Swedish Medical Birth Registry 1991, we made a cross-sectional study of the cesarean section rate at the departmental level. We identified some 20 determinants, demand-related as well as supply-related. A general model including all these regressors was specified. After reducing this model, we were able to explain about one-quarter of the variation. We conclude that the large variation in cesarean section rates indicates inefficiency, due mainly to overutilization, but perhaps also underutilization. It is difficult to calculate the economic consequences or the welfare loss to society. We estimated an additional cost for unnecessary cesarean sections of 13—16 million Swedish crowns (SEK) per year.

Keywords

Cesarean SectionPractice PatternsEconomicsRegression Analysis
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 14 , Issue 4 , Fall 1998 , pp. 774 - 787
Copyright
Copyright © Cambridge University Press 1998

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