title: [Variability in the cesarean ratio and indications for the procedure among Spanish hospitals].
abstract: OBJECTIVE
  To describe variability in the cesarean ratio and indications for this procedure in women with and without a previous cesarean section.
  
  
  METHODS
  We conducted a cross-sectional study of 111 hospitals (year 2010) categorized in six levels. Ten groups of indications for cesarean section were developed. Measures of central tendency and diversity were used to determine variability and the Kruskal-Wallis test was used for comparisons among hospital levels.
  
  
  RESULTS
  The percentage of cesarean sections was 25.4%. In women without a previous cesarean section, the percentage was higher in private and public hospitals with a lower technological level (34.7% and 30.4% in private and 22.4% in lower level public hospitals). Among public hospital levels, no differences in the percentage of cesarean sections indicated were observed.
  
  
  CONCLUSIONS
  Research on non-clinical factors could clarify the differences in the ratio of cesarean sections in private hospitals compared with public hospitals and among distinct levels of public hospitals.
authors.affiliation: Iasist SAU, Barcelona, España. aredondo@iasist.com
authors.forename: Ana
authors.initials: A
authors.lastname: Redondo
authors.forename: Mercedes
authors.initials: M
authors.lastname: Sáez
authors.forename: Patricia
authors.initials: P
authors.lastname: Oliva
authors.forename: Maria
authors.initials: M
authors.lastname: Soler
authors.forename: Antoni
authors.initials: A
authors.lastname: Arias
mesh_terms: D000328:Adult; D001946:Breech Presentation / Q000601:surgery; D002585:Cesarean Section / Q000706:statistics & numerical data*; D017604:Cesarean Section, Repeat / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D005316:Fetal Distress / Q000601:surgery; D016304:Hospitals, Private / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D007744:Obstetric Labor Complications / Q000601:surgery; D011247:Pregnancy; D013030:Spain; D018709:Statistics, Nonparametric