Factors Influencing the Caesarean Section Rates in German Hospitals in the Years 2015-2017 [18.10.21]
A joint study by the University of Hohenheim and Furtwangen University of Applied Sciences concludes that the number of caesarean sections is influenced by the regional level of education rather than population density.
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Original Study
Zipfel, L 1 & Weidmann L. 2 (2021) Factors Influencing the Caesarean Section Rates in German Hospitals in the Years 2015-2017: An Ecological Study. Das Gesundheitswesen, ISSN: 0941-3790, 1439-4421 (elektronisch) DOI:10.1055/a-1531-4998
Abstract
Background Studies in various other countries have shown that there are urban-rural differences in caesarean section rates. Most urban areas showed higher caesarean section rates. The aim of this study was to compare the caesarean section rates between hospitals in urban and rural areas in Germany, and to identify other factors affecting the caesarean section rate. Methods A secondary data analysis was carried out to investigate the present research topic. The years 2015-2017 were considered, using as data sources the quality reports of the hospitals. Using the statistical program SPSS, mean value comparisons and multiple linear regressions were conducted. Results The mean value analysis showed no significant differences in caesarean section rate between urban and rural hospitals (2015: urban hospitals=31.87% vs. rural hospitals=31.6%, 2016: urban hospitals=31.09% vs. rural hospitals=31.04%, 2017: urban hospitals=31.26% vs. rural hospitals: 31.03%). The multiple linear regression showed that the variables number of beds (2015: b=0.005, 2016: b=0.007, 2017: b=0.006), teaching activity (2015: b=- 1.42, 2016: b=- 1.351, 2017: b=- 1.823), number of gynaecologists per 100,000 inhabitants (2015: b=0.198, 2016: b=0.241, 2017: b=0.254) and the percentage of the population with a college/university degree (2015: b=- 0.45, 2016: b=- 0.507, 2017: b=- 0.392) were significant predictors of the caesarean section rate in all years of the study. Conclusion The study was able to identify hospital characteristics as well as population- and care-specific characteristics that have an influence on the caesarean section rate in a hospital. The average level of education in the district where the hospital was located was particularly relevant. Thus, caesarean section rates seem to be influenced less by population density than by the regional level of education. © 2021. Thieme
