Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.

<h4>Background</h4>The Australian Private Health Insurance Incentive (PHII) policy reforms implemented in 1997-2000 increased PHI membership in Australia by 50%. Given the higher rate of obstetric interventions in privately insured patients, the reforms may have led to an increase in sur...

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Autores principales:	Kristjana Einarsdóttir, Anna Kemp, Fatima A Haggar, Rachael E Moorin, Anthony S Gunnell, David B Preen, Fiona J Stanley, C D'Arcy J Holman
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/456e740208c64f52a356ce1af1acebad
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spelling	oai:doaj.org-article:456e740208c64f52a356ce1af1acebad2021-11-18T07:11:31ZIncrease in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.1932-620310.1371/journal.pone.0041436https://doaj.org/article/456e740208c64f52a356ce1af1acebad2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22844477/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The Australian Private Health Insurance Incentive (PHII) policy reforms implemented in 1997-2000 increased PHI membership in Australia by 50%. Given the higher rate of obstetric interventions in privately insured patients, the reforms may have led to an increase in surgical deliveries and deliveries with longer hospital stays. We aimed to investigate the effect of the PHII policy introduction on birth characteristics in Western Australia (WA).<h4>Methods and findings</h4>All 230,276 birth admissions from January 1995 to March 2004 were identified from administrative birth and hospital data-systems held by the WA Department of Health. Average quarterly birth rates after the PHII introduction were estimated and compared with expected rates had the reforms not occurred. Rate and percentage differences (including 95% confidence intervals) were estimated separately for public and private patients, by mode of delivery, and by length of stay in hospital following birth. The PHII policy introduction was associated with a 20% (-21.4 to -19.3) decrease in public birth rates, a 51% (45.1 to 56.4) increase in private birth rates, a 5% (-5.3 to -5.1) and 8% (-8.9 to -7.9) decrease in unassisted and assisted vaginal deliveries respectively, a 5% (-5.3 to -5.1) increase in caesarean sections with labour and 10% (8.0 to 11.7) increase in caesarean sections without labour. Similarly, birth rates where the infant stayed 0-3 days in hospital following birth decreased by 20% (-21.5 to -18.5), but rates of births with >3 days in hospital increased by 15% (12.2 to 17.1).<h4>Conclusions</h4>Following the PHII policy implementation in Australia, births in privately insured patients, caesarean deliveries and births with longer infant hospital stays increased. The reforms may not have been beneficial for quality obstetric care in Australia or the burden of Australian hospitals.Kristjana EinarsdóttirAnna KempFatima A HaggarRachael E MoorinAnthony S GunnellDavid B PreenFiona J StanleyC D'Arcy J HolmanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 7, p e41436 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kristjana Einarsdóttir Anna Kemp Fatima A Haggar Rachael E Moorin Anthony S Gunnell David B Preen Fiona J Stanley C D'Arcy J Holman Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.
description	<h4>Background</h4>The Australian Private Health Insurance Incentive (PHII) policy reforms implemented in 1997-2000 increased PHI membership in Australia by 50%. Given the higher rate of obstetric interventions in privately insured patients, the reforms may have led to an increase in surgical deliveries and deliveries with longer hospital stays. We aimed to investigate the effect of the PHII policy introduction on birth characteristics in Western Australia (WA).<h4>Methods and findings</h4>All 230,276 birth admissions from January 1995 to March 2004 were identified from administrative birth and hospital data-systems held by the WA Department of Health. Average quarterly birth rates after the PHII introduction were estimated and compared with expected rates had the reforms not occurred. Rate and percentage differences (including 95% confidence intervals) were estimated separately for public and private patients, by mode of delivery, and by length of stay in hospital following birth. The PHII policy introduction was associated with a 20% (-21.4 to -19.3) decrease in public birth rates, a 51% (45.1 to 56.4) increase in private birth rates, a 5% (-5.3 to -5.1) and 8% (-8.9 to -7.9) decrease in unassisted and assisted vaginal deliveries respectively, a 5% (-5.3 to -5.1) increase in caesarean sections with labour and 10% (8.0 to 11.7) increase in caesarean sections without labour. Similarly, birth rates where the infant stayed 0-3 days in hospital following birth decreased by 20% (-21.5 to -18.5), but rates of births with >3 days in hospital increased by 15% (12.2 to 17.1).<h4>Conclusions</h4>Following the PHII policy implementation in Australia, births in privately insured patients, caesarean deliveries and births with longer infant hospital stays increased. The reforms may not have been beneficial for quality obstetric care in Australia or the burden of Australian hospitals.
format	article
author	Kristjana Einarsdóttir Anna Kemp Fatima A Haggar Rachael E Moorin Anthony S Gunnell David B Preen Fiona J Stanley C D'Arcy J Holman
author_facet	Kristjana Einarsdóttir Anna Kemp Fatima A Haggar Rachael E Moorin Anthony S Gunnell David B Preen Fiona J Stanley C D'Arcy J Holman
author_sort	Kristjana Einarsdóttir
title	Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.
title_short	Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.
title_full	Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.
title_fullStr	Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.
title_full_unstemmed	Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.
title_sort	increase in caesarean deliveries after the australian private health insurance incentive policy reforms.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/456e740208c64f52a356ce1af1acebad
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Increase in caesarean deliveries after the Australian Private Health Insurance Incentive policy reforms.

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