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Variation in obstetric care within and between hospital levels in Finland
Author(s) -
Hemminki Elina,
Gissler Mika
Publication year - 1994
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1994.tb13545.x
Subject(s) - psychological intervention , variation (astronomy) , medicine , logistic regression , regional variation , pregnancy , obstetrics , demography , nursing , physics , sociology , biology , astrophysics , political science , law , genetics
Objective In obstetrics, both area and hospital variation has previously been documented for operative procedures, but not for other treatments or diagnostic procedures. This study investigated the extent of variation in care during pregnancy, at birth and after birth. Design and methods The variation was studied by hospitals ( n = 52 ) by hospital level. To account for differences in women's background characteristics, logistic regression analyses were done. The data came from the 1991 Finnish Birth Register which records data on all births ( n = 64 171). Results All interventions and care practices studied varied notably from one hospital to another, with the variation usually being greater within hospitals of the same level than between hospitals of different levels. Each of the seven non‐operative interventions showed a larger variation than did each of the four operative interventions. Standardisation for mothers’ background characteristics did not eliminate this variation. Some interventions, but not all, were clustered in the same hospitals. Conclusions Such large variation indicates a need for further studies on the benefits of obstetric interventions and of care practices, and on better application of research results to obstetric care.