An epidemic of avoidable caesarean deliveries in the private sector in India: Is physician-induced demand at play?

Social Science & Medicine
M BhatiaP Dixit

Abstract

Caesarean section (C-section) rates of over 15% suggest overuse of the surgery which may be difficult to justify on medical grounds. One important contributor to the rise in Csection rates is the rapid expansion of unregulated private-sector providers in number of settings. This study analyses the contribution of private sector in the rapid rise in Csection deliveries in India and the extent to which these can be justified on medical grounds. This is a cross sectional study design using National Family Health Surveys. Logistic regression and propensity score matching (PSM) analyses are performed. The main outcome measured is avoidable C-sections in the private sector. Our findings suggest that the rising trend in C-section rates in the private sector cannot be explained by medical reasons alone. The odds of C-section among women who chose to deliver in private was over 4 times higher than women who chose to delivery in public facilities. Despite, controlling for medical complications, women's characteristics and preferences, our PSM analysis suggest that the public-private gap has doubled over the years and that the difference cannot be explained by known determinants of C-section. Over supply of avoidable C-section to the exte...Continue Reading

References

Oct 28, 1999·Journal of Health Economics·J GruberD Mayzlin
May 9, 2006·American Journal of Obstetrics and Gynecology·Shenglan TangZhuochun Wu
Jun 7, 2006·Lancet·Cesar G Victora, Fernando C Barros
Feb 25, 2014·Social Science & Medicine·Chin-Shyan ChenChung-Liang Lin
Sep 12, 2015·Journal of Health Economics·Irene Papanicolas, Alistair McGuire
Dec 19, 2015·BJOG : an International Journal of Obstetrics and Gynaecology·A P BetranUNKNOWN WHO Working Group on Caesarean Section
Jan 13, 2017·Lancet·Shannon BrownleeDeborah Korenstein
Feb 10, 2019·Social Science & Medicine·Sanjay K MohantyPriyamadhaba Behera

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