Caesarean birth rates in public and privately funded hospitals: a cross-sectional study
Rev. saúde pública (Online)
; 51: 101, 2017. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-903199
Biblioteca responsável:
BR1.1
ABSTRACT
ABSTRACT OBJECTIVE To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women's maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
Problema de saúde:
Objetivo 11 Desigualdades e iniquidades na saúde
Base de dados:
LILACS
Assunto principal:
Resultado da Gravidez
/
Cesárea
/
Hospitais Privados
/
Saúde da Mulher
/
Hospitais Públicos
Tipo de estudo:
Estudo observacional
/
Estudo de prevalência
/
Fatores de risco
Aspecto:
Equidade e iniquidade
Limite:
Adolescente
/
Adulto
/
Feminino
/
Humanos
/
Gravidez
País/Região como assunto:
América do Sul
/
Brasil
Idioma:
Inglês
Revista:
Rev. saúde pública (Online)
Assunto da revista:
Sa£de P£blica
Ano de publicação:
2017
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Universidade de São Paulo/BR