Estimating caesarean section rates in medical schemes, South | 17986
International Research Journals

Estimating caesarean section rates in medical schemes, South Africa: A comparative study between 2008 and 2011


Mncedisi Michael Willie

Caesarean section rates in the private sector are r eported amongst the highest in the world, these procedures are also reported to be costly to medica l schemes. The objective of this study was to exami ne caesarean section rates in large and medium medical schemes in South Africa. This was a comparative cross-sectional study on the 2008 and 2011 data. Mu ltivariate analysis of variance (MANOVA) was conducted to measure CS rate characteristics to fac tors such as scheme type, pregnancy rates in schemes and the average age of beneficiaries. The average age of beneficiaries in open schemes increased marginally from 30.0 in 2008 to 30.4 year s in 2011; however there was slight ageing in restr icted schemes from 29.7 2008 to 29.9 years in 2011. Media n CS rate per 1000 deliveries increased from 618.2 IQR (546.2-677.0) in 2008 to 680.1 IQR (634.2-730.5 ) in 2011. Pregnancy rate also increased slightly f rom 2.5 IQR (1.9-3.5) in 2008 to 3.0 IQR (2.4-3.7) per 100 female beneficiaries in 2011. The current paper indicates an ageing phenomenon in child bearing ben eficiaries; an increasing trend is also noted in caesarean rates. Covariates considered in the curre nt study were not significantly associated with CS rates, thus indicating that other factors such clin ical notes on CS rates; maternal perspective and provider perspective need to be explored further to enhance the understanding on drivers of increasing CS rates.

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