Promoting epidural analgesia for labor: 2005-2007 diffusion in Lombardia, Italy

Area of Science:

• Obstetrics and Gynecology
• Public Health Policy
• Pain Management

Background:

• Lombardia, a major Italian region, allocated public funds for epidural analgesia (EA) from 2005-2007.
• The study aimed to assess the trend in EA utilization during this funding period.

Purpose of the Study:

• To evaluate the trend and diffusion of epidural analgesia (EA) in Lombardia between 2005 and 2007.
• To determine the impact of regional public funding on EA adoption rates.

Main Methods:

• Utilized administrative patient records from regional Obstetric Departments.
• Analyzed data using specific codes for vaginal deliveries with and without EA, and Cesarean sections.
• Data were processed by the Epidemiological Service of Regione Lombardia.

Main Results:

• Epidural analgesia (EA) rates increased significantly, from 8.2% in 2005 to 12.9% in 2007.
• Hospitals with >2000 births/year showed higher EA rates (24.9% in 2007) compared to smaller hospitals (<2000 births/year, 7.8% in 2007).
• Cesarean section rates remained unchanged throughout the study period.

Conclusions:

• The rise in EA use following public funding indicates that economic and organizational barriers were primary limitations.
• Cultural or psychological factors were less significant in the low adoption of labor pain relief.