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Published on: January 17, 2019
Cesarean births in Taiwan
Chin-Yuan Hsu1, J C Lo, Jui-Hsing Chang
1Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan. hsu4426@ms4.hinet.net
Summary
Cesarean delivery rates in Taiwan are high, particularly in clinics, with prior cesarean section being the most common indication. These findings offer insights for countries with universal health insurance.
Area of Science:
- Obstetrics and Gynecology
- Health Services Research
- Public Health
Background:
- Cesarean delivery rates vary globally, influenced by clinical practices and healthcare systems.
- Understanding local indications is crucial for evaluating obstetric practices.
Purpose of the Study:
- To compare cesarean delivery indications in Taiwan with international data.
- To evaluate the utilization of cesarean delivery within Taiwan's healthcare system.
Main Methods:
- Analysis of inpatient claims data from Taiwan's National Health Insurance (NHI) from 1998-2000.
- Evaluation of cesarean delivery indications using primary diagnosis and procedure codes.
- Comparison of Taiwanese rates with international cohorts.
Main Results:
- Primary cesarean delivery rates were 27.3%-28.7%, with vaginal birth after cesarean section (VBAC) below 5%.
- Taiwanese rates for overall and primary cesarean section, and VBAC, were significantly higher than international benchmarks.
- Prior cesarean section (43.3%-45.5%) and malpresentation (19.6%-23.4%) were the leading indications; malpresentation cesarean rates were nearly double international expectations.
Conclusions:
- Comparing local obstetric data with international benchmarks is vital for monitoring practices.
- High cesarean delivery rates in Taiwan, especially in clinics, provide valuable lessons for universal health insurance systems globally.
