The purpose of this study was to determine whether women's sociodemographic characteristics are independently associated with cesarean delivery.
A retrospective review was conducted of hospital dischargde data for singleton first births in California in 1991.
After insurance and personnal, community, medical, and hospital characteristics had been controlled, Blacks were 24% more likely to undergo cesarean delivery than Whites ; only among low-birthweight and county hospital births were Blacks not at a significantly elevated risk.
Among women who resided in substantially non-English-speaking communities, who delivered high-birthweight babies, or who gave birth at for-profit hospitals, cesarean delivery appeared to be more likely among non-Whites and was over 40% more likely among Blacks than among Whites.
The finding cannot establish causation, but the significant radical/ethnic disparities in delivery mode, despite adjustment for social, economic, medical, and hospital factors, suggest inappropriate influences on clinical decision making that would not be addressed by changes in reimboursement.
If practiced variations amoung providers are involved, de facto racial differences in access to optimal care may be indicated.
The role of provider and patient attitudes and expectations in the observed racial/ethnic differentials should also be explored.
Mots-clés Pascal : Césarienne, Epidémiologie, Race, Ethnie, Californie, Etats Unis, Amérique du Nord, Amérique, Statut socioéconomique, Homme, Femelle, Indication, Chirurgie
Mots-clés Pascal anglais : Cesarean section, Epidemiology, Race, Ethnic group, California, United States, North America, America, Socioeconomic status, Human, Female, Indication, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0318223
Code Inist : 002B20G02. Création : 01/03/1996.