Provider-associated factors in obstetric interventions.
OBJECTIVE
To assess which factors influence provider-associated differences in obstetric interventions.


METHODS
A survey of obstetricians and co-workers in a sample consisting of 38 Dutch hospitals was taken, using a questionnaire that contained questions about personal and hospital-policy data, and 19 clinical problems with a choice between intervention and non-intervention. From the clinical problems an Intervention Score was assembled. The influence of the personal and hospital-policy items on this Intervention Score was studied by analysis of variance.


RESULTS
Overall the Intervention Score was low, with considerable interindividual variation. Four personal/hospital items influenced the Intervention Score: the teacher could affect the score in either direction; the increasing age of the obstetrician and routine electronic fetal monitoring had an increasing effect; employment of midwives had a decreasing effect. Other factors, including litigation, had no effect.


CONCLUSIONS
Supplier-induced differences do exist in obstetric interventions and are influenced by personal and hospital-policy factors.
Pel
M
M
Department of Obstetrics and Gynecology, University of Amsterdam, The Netherlands.
Heres
M H
MH
Hart
A A
AA
van der Veen
F
F
Treffers
P E
PE
D000328:Adult; D000368:Aged; D002585:Cesarean Section; D005260:Female; D005323:Fetal Monitoring; D006291:Health Policy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008880:Midwifery; D009426:Netherlands; D009774:Obstetrics; D010819:Physician's Role; D011247:Pregnancy; D011795:Surveys and Questionnaires