Nighttime call in house vs. out of house: a comparison of obstetric procedure rates.
OBJECTIVE
To evaluate the effect of in-house vs. out-of-house nighttime call coverage on obstetric practice.


METHODS
A retrospective analysis was performed on nighttime deliveries. Included were deliveries by 2 faculty groups that equally shared in-house and out-of-house call coverage. Included patients had an equal chance of delivering with a physician on call covering in house or out of house. Patient demographics and obstetric outcomes were compared between in-house and out-of-house call status for the delivering physician by ANOVA and chi2.


RESULTS
Of eligible nighttime deliveries, 230 were identified, 120 with in-house and 110 with out-of-house call coverage. Demographic features were not statistically different between the groups. A comparison of in-house and out-of-house deliveries yielded rates for episiotomy (28.3% vs. 30.0%), cesarean delivery (26.7% vs. 21.8%), operative vaginal delivery (11.7% vs. 18.2%), total operative delivery (38.4% vs. 40.0%) and nonoperative vaginal delivery (61.7% vs. 60.0%) that did not significantly differ by physician call status.


CONCLUSIONS
The nighttime call status of physicians, whether in house or out of house, did not affect cesarean delivery, operative vaginal delivery, overall (total) operative delivery or episiotomy rates.
Goldberg
Jay
J
Department of Obstetrics and Gynecology, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA. jay.goldberg@jefferson.edu
Gopal
Manish
M
Singhal
Richa
R
Mitchell
Christina
C
Culhane
Jennifer
J
Webb
David A
DA
D000328:Adult; D039602:After-Hours Care / Q000706:statistics & numerical data*; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008505:Medical Staff, Hospital; D009551:Night Care; D009774:Obstetrics / Q000706:statistics & numerical data*; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data; D015143:Philadelphia / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D012189:Retrospective Studies; D000078329:Workforce; D016526:Workload / Q000706:statistics & numerical data