Setting goals for reductions in Canadian cesarean delivery rates: benchmarking medical practice patterns.

Abstract

The objective of this study was to present a structured method for determining achievable cesarean rate goals and specifying which hospitals should receive focused attention. Hospital level data from the largest 239 Canadian maternity units were analyzed for 1988-1989, when the number of Canadian cesarean deliveries peaked. Cesarean rate statistical limits within the largest, intermediate-sized, and smallest maternity unit classifications were successively set at the 75th, 50th, and 25th percentiles. The national impact resulting from using the 75th percentile rate as the assigned statistical cesarean rate limit was 2707 (50th 5568; 25th 11,018) fewer cesarean deliveries. Benchmarking provides a structured perspective on defining goals and on estimating how much change is required and at which hospitals.