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Observational Study
. 2020 Jan 4;7(2):627-633.
doi: 10.1002/nop2.433. eCollection 2020 Mar.

Geospatial variation in caesarean delivery

Jennifer Vanderlaan  1 , Johnathan A Edwards  2 , Anne Dunlop  3
Affiliations
Observational Study

Geospatial variation in caesarean delivery

Jennifer Vanderlaan et al. Nurs Open. .

Abstract

Aim: 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.

Design: This was a retrospective, observational study.

Methods: 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.

Results: 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.

Keywords: caesarean section; maternal health services; nurses; nursing; spatial analysis.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

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