Variation in hospital rates of induction of labour: a population-based record linkage study

BMJ Open
T A NippitaChristine L Roberts

Abstract

To examine interhospital variation in rates of induction of labour (IOL) to identify potential targets to reduce high rates of practice variation. Population-based record linkage cohort study. New South Wales, Australia, 2010-2011. All women with live births of ≥24 weeks gestation in 72 hospitals. Variation in hospital IOL rates adjusted for differences in case-mix, according to 10 mutually exclusive groups derived from the Robson caesarean section classification; groups were categorised by parity, plurality, fetal presentation, prior caesarean section and gestational age. The overall IOL rate was 26.7% (46,922 of 175,444 maternities were induced), ranging from 9.7% to 41.2% (IQR 21.8-29.8%) between hospitals. Nulliparous and multiparous women at 39-40 weeks gestation with a singleton cephalic birth were the greatest contributors to the overall IOL rate (23.5% and 20.2% of all IOL respectively), and had persisting high unexplained variation after adjustment for case-mix (adjusted hospital IOL rates ranging from 11.8% to 44.9% and 7.1% to 40.5%, respectively). In contrast, there was little variation in interhospital IOL rates among multiparous women with a singleton cephalic birth at ≥41 weeks gestation, women with singleton non...Continue Reading

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Citations

Mar 13, 2016·Acta Obstetricia Et Gynecologica Scandinavica·Tanya A NippitaChristine L Roberts
May 16, 2017·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Yihui ZhangYimin Dai
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Aug 28, 2020·The Cochrane Database of Systematic Reviews·Zarko AlfirevicElaine M Finucane
Sep 25, 2017·BMC Pregnancy and Childbirth·Tanya A NippitaChristine L Roberts
Jul 2, 2020·BMC Pregnancy and Childbirth·Susan DongRohan D'Souza
May 27, 2021·Women and Birth : Journal of the Australian College of Midwives·Heather Artuso, Deborah L Davis
Jul 18, 2020·Women and Birth : Journal of the Australian College of Midwives·Coates DominiekHenry Amanda
Jun 8, 2021·Australian Health Review : a Publication of the Australian Hospital Association·Katherine B OwenSiranda Torvaldsen
Dec 13, 2016·Pediatrics·Jason P BentleyNatasha Nassar

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