To assess which factors influence provider-associated differences in obstetric interventions.
- A survey of obstetricians and co-workers in a sample consisting of 38 Dutch hospitals was taken, using a questionnaire that contained questions about personal and hospital-policy data, and 19 clinical problems with a choice between intervention and non-intervention.
From the clinical problems an Intervention Score was assembled.
The influence of the personal and hospital-policy items on this Intervention Score was studied by analysis of variance.
Overall the Intervention Score was low, with considerable interindividual variation.
Four personal/hospital items influenced the Intervention Score :
the teacher could affect the score in either direction ;
the increasing age of the obstetrician and routine electronic fetal monitoring had an increasing effect ;
employment of midwives had a decreasing effect.
Other factors, including litigation, had no effect.
Supplier-induced differences do exist in obstetric interventions and are influenced by personal and hospital-policy factors.
Mots-clés Pascal : Traitement, Homme, Chirurgie, Obstétrique, Médecin, Choix, Césarienne, Enquête, Sage femme, Pays Bas, Europe
Mots-clés Pascal anglais : Treatment, Human, Surgery, Obstetrics, Physician, Choice, Cesarean section, Inquiry, Midwife, Netherlands, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0466687
Code Inist : 002B20G02. Création : 01/03/1996.