Responded to: AAFP PBRN Stimulation Grant Application
A Comparison of Cesarean Section Outcomes for Rural Obstetricians and Family Physicians
ABSTRACT
The proposed study is a retrospective descriptive study to compare the specific and overall complications of Cesarean sections performed in rural hospitals by family physicians and obstetricians. Data will be obtained by chart abstraction and billing data. The first phase of the study will be a pilot study in two New England community hospitals. At one hospital, all Cesareans are performed by family physicians. At a nearby hospital with similar patient demographics, obstetricians perform all C-sections. The 125 most recent C-sections will be studied in each hospital. This will represent 2-5 years experience at the selected hospitals.
Outcomes data to be studied will be: maternal death, fetal death, Apgar score, newborn transfer to NICU, hemorrhage requiring transfusion, hemorrhage requiring Cesarean-hysterectomy, post-op infection, bowel injury, bladder injury, wound dehiscence, length of stay, length of procedure, and decision to incision time. Basic demographic data will be obtained to confirm appropriate controls, including age, parity, insurance status, race and maternal medical conditions. Data will be collected by the principal investigator or her designee, following appropriate training in chart review and billing data collection techniques. Data will be analyzed using standard statistical methods.
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