Impact of the EURO-PERISTAT Reports on obstetric management: a difference-in-regression-discontinuity analysis.
Eur J Public Health
; 33(2): 342-348, 2023 04 01.
Article
in En
| MEDLINE
| ID: mdl-36807668
ABSTRACT
BACKGROUND:
Population health monitoring, such as perinatal mortality and morbidity rankings published by the European Perinatal Health (EURO-PERISTAT) reports may influence obstetric care providers' decision-making and professional behaviour. We investigated short-term changes in the obstetric management of singleton term deliveries in the Netherlands following publication of the EURO-PERISTAT reports in 2003, 2008 and 2013.METHODS:
We used a quasi-experimental difference-in-regression-discontinuity approach. National perinatal registry data (2001-15) was used to compare obstetric management at delivery in four time windows (1, 2, 3 and 5 months) surrounding publication of each EURO-PERISTAT report.RESULTS:
The 2003 EURO-PERISTAT report was associated with higher relative risks (RRs) for an assisted vaginal delivery across all time windows [RR (95% CI) 1 month 1.23 (1.05-1.45), 2 months 1.15 (1.02-1.30), 3 months 1.21 (1.09-1.33) and 5 months 1.21 (1.11-1.31)]. The 2008 report was associated with lower RRs for an assisted vaginal delivery at the 3- and 5-month time windows [0.86 (0.77-0.96) and 0.88 (0.81-0.96)]. Publication of the 2013 report was associated with higher RRs for a planned caesarean section across all time windows [1 month 1.23 (1.00-1.52), 2 months 1.26 (1.09-1.45), 3 months 1.26 (1.12-1.42) and 5 months 1.19(1.09-1.31)] and lower RRs for an assisted vaginal delivery at the 2-, 3- and 5-month time windows [0.85 (0.73-0.98), 0.83 (0.74-0.94) and 0.88 (0.80-0.97)].CONCLUSIONS:
This study showed that quasi-experimental study designs, such as the difference-in-regression-discontinuity approach, are useful to unravel the impact of population health monitoring on decision-making and professional behaviour of healthcare providers. A better understanding of the contribution of health monitoring to the behaviour of healthcare providers can help guide improvements within the (perinatal) healthcare chain.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Maternal Health Services
Type of study:
Diagnostic_studies
Limits:
Female
/
Humans
/
Newborn
/
Pregnancy
Country/Region as subject:
Europa
Language:
En
Journal:
Eur J Public Health
Journal subject:
EPIDEMIOLOGIA
/
SAUDE PUBLICA
Year:
2023
Document type:
Article
Affiliation country:
Netherlands