:: Volume 4, Issue 3 (Military Caring Sciences 2018) ::
MCS 2018, 4(3): 207-212 Back to browse issues page
The Effect of Healthcare Reform Plan to Reduce the Rate of Cesarean in Hospitals Affiliated to Qom University of Medical Sciences
Fouladi. Z 1, Shaarbafchi Zadeh. N2, Shaikhvaisi. Y3, Alimoradnuri. M4, Bagheri. F5
1- Iran, Isfahan, Isfahan University of Medical Sciences, Faculty of Management and Information Technology, Health Services Management.
2- Iran, Isfahan, Isfahan University of Medical Sciences, Faculty of Management and Medical Information, Health Services Management Department
3- , Iran, Tehran, Instructor, AJA University of Medical Sciences, Faculty of Paramedicine, Epidemiology and Health Department.
4- , Iran, Tehran, Isfahan University of Medical Sciences.
5- Iran, Qom, Qom University of Medical Sciences.
Abstract:   (5486 Views)

Introduction: Nowadays, cesarean is one of the most common surgeries in the world and also one of the challenges concerning women’s health in developed and developing countries. Providing safe conditions for childbirth is the most important public health obligations. One of the eight packages of the Iranian healthcare reform plan is to promote vaginal delivery.
Objectives: The aim of this study was to compare the rate of caesarean two years before and two years after implementing the healthcare reform plan.
Materials and Methods: This descriptive-analytic, retrospective, study was conducted in public hospitals affiliated to Qom University of Medical Sciences during 2012-2015. The study population consisted of all births in hospitals and was about 133480. Data were collected by the Department of Health in Qom city, and then were analyzed using the Spearman’s correlation coefficient by the SPSS software version 23.
Results: The results of the hypothesis test based on the Spearman correlation coefficient showed that there was no significant difference in the reduction of the number of cesarean operations before and after the implementation of the healthcare reform plan (r = 142 and P<0.05)
Discussion and Conclusion: Implementation of the healthcare reform has reduced the rate of cesarean in the hospitals. The statistical comparison calculated before and after the implementation of the healthcare reform plan shows that the rate of cesarean in hospital (A) decreased by 8.4%, while in hospital (B) reduced 3.4%. However, the achievement of the goals of the plan to reduce the proportion of cesarean delivery up to 10% per year has not been fully realized.

Keywords: Cesarean Section, Healthcare Reform Plan, Vaginal Delivery.
Full-Text [PDF 338 kb]   (1039 Downloads)    
Type of Study: Applicable | Subject: Special
Received: 2016/08/10 | Accepted: 2017/11/7 | Published: 2017/12/24
1. shariat M, Ehdaeevand F, Ataie M, Karami Z, Hadipoor Jahromi LHJ, Farahani Z. Effectiveness of community based intervention on improvement of pregnancy and delivery process in district 4 of Tehran. Tehran Univ Med J. 2015;73(7):527-34.
2. Health Mo. Statistics cesarean section in Iran is 25 percent higher than the global rate Tehran: Aftab News; 2015 [cited 2017 May 14]. Available from: http://aftabnews.ir/fa/news/125280.
3. Azizi F. Delivery with cesarean section: Shocking addiction. Med Res. 2007;31(3):191-3.
4. Arab M. Comparison of the cost and complications of normal delivery after cesarean section with repeated cesarean section. Sci J Hamadan Univ Med Sci. 2001;8(2):29-33.
5. Chaillet N, Dumont A. Evidence-based strategies for reducing cesarean section rates: a meta-analysis. Birth. 2007;34(1):53-64. DOI: 10.1111/j.1523-536X.2006.00146.x PMID: 17324180
6. Menacker F, Hamilton BE. Recent trends in cesarean delivery in the United States. NCHS Data Brief. 2010(35):1-8. PMID: 20334736
7. Mawson AR. Reducing cesarean delivery rates in managed care organizations. Am J Manag Care. 2002;8(8):730-40. PMID: 12212760
8. Shiono PH, McNellis D, Rhoads GG. Reasons for the rising cesarean delivery rates: 1978-1984. Obstet Gynecol. 1987;69(5):696-700. PMID: 3574796
9. Menacker F. Trends in cesarean rates for first births and repeat cesarean rates for low-risk women: United States, 1990-2003. Natl Vital Stat Rep. 2005;54(4):1-8. PMID: 16220739
10. Belizan JM, Althabe F, Barros FC, Alexander S. Rates and implications of caesarean sections in Latin America: ecological study. BMJ. 1999;319(7222):1397-400. PMID: 10574855
11. Tavassoly A, Clary F, Zafaridizagi A. Social factors influencing the trend towards caesarean section in pregnant women. J Med Ethics. 2014;8(29):145-69.
12. Shakeryan B. Frequency of Cesarean do Chaharmahal & Bakhtiari province. J Shahrekord Univ Med Sci. 2003;1(6):63-9.
13. Society IM. The average rates of the country Iran: Mashregh News; 2017 [cited 2017 May 14]. Available from: http://www.mashreghnews.ir/news/306840.
14. Abedyan Z, Nikpor M, Ebrahem Zade S, Khani S. The relationship between delivery and quality of life after delivery. Iranian J Obstet Gynecol Infert. 2010;3(13):47-53.
15. Afshari S, Ebrahimzadeh J, Soleimani F. The impact of healthcare reform on rate in hospitals affiliated to Isfahan University of Medical Sciences. International Conference on sustainable development of the health system; Iran2015

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