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Setting goals for reductions in Canadian cesarean delivery rates: benchmarking medical practice patterns
1AlgoPlus Consulting Limited, 5675 Spring Garden Road, Suite 502, Halifax, Nova Scotia, Canada B3J 1H1.
Objective:
The objective of this study was to present a structured method for determining achievable cesarean rate goals and specifying which hospitals should receive focused attention.
Study Design:
Hospital level data from the largest 239 Canadian maternity units were analyzed for 1988-1989, when the number of Canadian cesarean deliveries peaked. Cesarean rate statistical limits within the largest, intermediate-sized, and smallest maternity unit classifications were successively set at the 75th, 50th, and 25th percentiles.
Results:
The national impact resulting from using the 75th percentile rate as the assigned statistical cesarean rate limit was 2707 (50th 5568; 25th 11,018) fewer cesarean deliveries.
Conclusion:
Benchmarking provides a structured perspective on defining goals and on estimating how much change is required and at which hospitals.