医生网络和选择性产科干预的兴起
Will Schupmann1, Julien Teitler2, Nancy E Reichman3
1Department of Sociology, University of California, Los Angeles, United States.
Social science & medicine (1982)
|December 6, 2025
概括
医生网络影响产科干预. 同行剖腹产和诱导增加,但同行对剖腹产的影响在2007年之后由于指导方针而减少.
科学领域:
- 产科和妇科 产科和妇科
- 医学社会学 医学社会学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 低风险怀孕中剖腹产和分娩诱导率的上升缺乏明确的解释.
- 医生实践模式可能受到专业网络中的社会动态的影响.
研究的目的:
- 调查医生之间的同行影响在推动产科干预趋势中的作用.
- 分析社交网络和临床谨慎如何影响剖腹产和诱导的采用.
主要方法:
- 在新泽西州 (1997-2014) 分析了170,151例低风险分娩,使用医院和医生数据进行了链接.
- 医生同行组的定义基于邻近,医院附属和共同出席.
- 多层次的后勤和波桑回归模型,以评估同行行为和个人医生实践之间的关联.
主要成果:
- 当他们的同行这样做时,医生更有可能进行干预,特别是在更高的相互作用概率的情况下.
- 对剖腹产率的同行影响在2007年后下降,与政策变化相吻合.
- 同行对诱导率的影响仍然很大,这表明具有更大的临床自由裁量权的更强效应.
结论:
- 医生网络中的社会影响是医疗实践变化的重要,尽管微妙的因素.
- 同行影响是由专业联系的强度和机构指导方针的明确性所调节的.
- 了解社会传播对于解决产科干预的趋势和促进基于证据的实践至关重要.
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