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dc.contributor.authorNorum, Jan
dc.contributor.authorSvee, Tove Elisabeth
dc.date.accessioned2019-03-08T09:21:43Z
dc.date.available2019-03-08T09:21:43Z
dc.date.issued2018-07-16
dc.description.abstract<i>Objective</i>: Caesarean section (CS) rates vary significantly worldwide. ,e World Health Organization (WHO) has recommended a maximum CS rate of 15%. Norwegian hospitals are paid per CS (activity-based funding), employing the diagnosis-related group (DRG) system. We aimed to document how financial incentives can be affected by reduced CS rates, according to the WHO’s recommendation. <p> <p><i>Methods</i>: We employed a model-based analysis and included the 2016 data from the Norwegian Patient Registry (NPR) and the Medical Birth Registry of Norway (MBRN). ,e vaginal birth rate and CS rates of each hospital trust in Northern Norway were analyzed. <p> <p><i>Results</i>: There were 4,860 deliveries and a 17.5% CS rate (range 13.9–20.3%). ,e total funding of the deliveries was €16,351,335 (CS: €6,389,323; vaginal births: €9,962,012). ,e CS rate varied significantly and was lower in the southern region (<i>P</i> < 0.002). Consequently, the introduction of a cutoff at a 15% CS rate would gain the two southern hospital trusts by a budget increase of 0.2%. ,e two northern ones would experience 6.4% less resources. A total of €644,655 could be allocated to further quality and safety initiatives in obstetrics. <p> <p><i>Conclusion</i>: The economic consequences of the model-based financial incentive were low, but probably sufficient to get the necessary attention and influence on the CS rate. <p> <p><i>Recommendations</i>: A financial incentive for the reduction of CS rates should be tested as a supplement to other instruments.en_US
dc.descriptionSource at <a href=https://doi.org/10.1155/2018/6764258>https://doi.org/10.1155/2018/6764258. </a>en_US
dc.identifier.citationNorum, J. & Svee, T.E. (2018). Caesarean section rates and activity-based funding in Northern Norway: A model-based study using the World Health Organization's recommendation. <i>Obstetrics and Gynecology International</i>, 6764258. https://doi.org/10.1155/2018/6764258en_US
dc.identifier.cristinIDFRIDAID 1616241
dc.identifier.doi10.1155/2018/6764258
dc.identifier.issn1687-9589
dc.identifier.issn1687-9597
dc.identifier.urihttps://hdl.handle.net/10037/14903
dc.language.isoengen_US
dc.publisherHindawi Publishing Corporationen_US
dc.relation.journalObstetrics and Gynecology International
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801en_US
dc.titleCaesarean section rates and activity-based funding in Northern Norway: A model-based study using the World Health Organization's recommendationen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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