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Geospatial variation in caesarean delivery.

Authors
  • Vanderlaan, Jennifer1
  • Edwards, Johnathan A2
  • Dunlop, Anne3
  • 1 University of Nevada Las Vegas School of Nursing Las Vegas NV.
  • 2 Department of Biomedical Informatics Emory University School of Medicine Atlanta GA.
  • 3 Nell Hodgson Woodruff School of Nursing Emory University Atlanta GA.
Type
Published Article
Journal
Nursing open
Publication Date
Mar 01, 2020
Volume
7
Issue
2
Pages
627–633
Identifiers
DOI: 10.1002/nop2.433
PMID: 32089861
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The purpose of this study was to evaluate the variation in caesarean delivery rates across counties in Georgia and to determine whether county-level characteristics were associated with clusters. This was a retrospective, observational study. Rates of primary and repeat caesarean by maternal county of residence were calculated for 2008 through 2012. Global Moran's I (Spatial Autocorrelation) was used to identify geographic clustering. Characteristics of high and low-rate counties were compared using student's t test and chi-squared test. Spatial analysis of both primary and repeat caesarean rate identified the presence of clusters (Moran's I = 0.375; p < .001). Counties in high-rate clusters had significantly lower access to midwives, more deliveries paid by Medicaid, higher proportion of births for women belonging to racial/ethnic minority groups and were more likely to be rural. © 2019 The Authors. Nursing Open published by John Wiley & Sons Ltd.

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