The Influence of Hospitals, Providers, and Patients in Birth Outcomes Following Induction of Labor

Persistent Link:
http://hdl.handle.net/10150/195171
Title:
The Influence of Hospitals, Providers, and Patients in Birth Outcomes Following Induction of Labor
Author:
Wilson, Barbara Lynn
Issue Date:
2008
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Strategies to optimize birth outcomes are a top priority in the current health care delivery system, where the examination and elimination of health disparities in childbearing women remain an important public health objective. Several studies have examined the relationships between socioeconomic status (SES), occupational status, ethnicity, insurance status, health care utilization, and educational level on birth outcomes, all known to influence gestational age and newborn mortality. Lesser-known variables are the influence of provider practice and hospital characteristics on birth outcomes.The purpose of this study was to evaluate several dimensions of birth outcomes employing birth certificate records and information available from provider licensing surveys for a one year period to calculate how much variation was due to differences in; a) hospital organizational characteristics; b) provider characteristics; and c) patient socio-demographic characteristics.The Quality Health Outcomes Model by Mitchell et al. (1998) provided a valuable framework which allowed the analysis of the interplay between intervention, client, and system characteristics, and their impact on birth outcomes for Maricopa County in 2005.The study design was a retrospective descriptive study using secondary data analysis with a dataset (Arizona HealthQuery, housed at the Center for Health Information and Research at Arizona State University) that included birth certificate information and the physician licensing renewal surveys.Secondary data analysis of this large administrative dataset provided the advantage of having a large sample size (62,816) of demographically diverse cases, thus minimizing concerns related to sample size and generalizability. Multiple regression and non-linear estimation models were deployed to control for confounding and effect modifying variables that could influence the relationship of labor induction on birth outcomes, including prolonged labor, use of forceps or vacuum extractors, cesarean births, Apgar scores, and newborn intensive care unit (NICU) admission.
Type:
text; Electronic Dissertation
Keywords:
birth outcomes; delivery; providers; hospital; patient characteristics
Degree Name:
PhD
Degree Level:
doctoral
Degree Program:
Nursing; Graduate College
Degree Grantor:
University of Arizona
Advisor:
Effken, Judith A.
Committee Chair:
Effken, Judith A.

Full metadata record

DC FieldValue Language
dc.language.isoENen_US
dc.titleThe Influence of Hospitals, Providers, and Patients in Birth Outcomes Following Induction of Laboren_US
dc.creatorWilson, Barbara Lynnen_US
dc.contributor.authorWilson, Barbara Lynnen_US
dc.date.issued2008en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractStrategies to optimize birth outcomes are a top priority in the current health care delivery system, where the examination and elimination of health disparities in childbearing women remain an important public health objective. Several studies have examined the relationships between socioeconomic status (SES), occupational status, ethnicity, insurance status, health care utilization, and educational level on birth outcomes, all known to influence gestational age and newborn mortality. Lesser-known variables are the influence of provider practice and hospital characteristics on birth outcomes.The purpose of this study was to evaluate several dimensions of birth outcomes employing birth certificate records and information available from provider licensing surveys for a one year period to calculate how much variation was due to differences in; a) hospital organizational characteristics; b) provider characteristics; and c) patient socio-demographic characteristics.The Quality Health Outcomes Model by Mitchell et al. (1998) provided a valuable framework which allowed the analysis of the interplay between intervention, client, and system characteristics, and their impact on birth outcomes for Maricopa County in 2005.The study design was a retrospective descriptive study using secondary data analysis with a dataset (Arizona HealthQuery, housed at the Center for Health Information and Research at Arizona State University) that included birth certificate information and the physician licensing renewal surveys.Secondary data analysis of this large administrative dataset provided the advantage of having a large sample size (62,816) of demographically diverse cases, thus minimizing concerns related to sample size and generalizability. Multiple regression and non-linear estimation models were deployed to control for confounding and effect modifying variables that could influence the relationship of labor induction on birth outcomes, including prolonged labor, use of forceps or vacuum extractors, cesarean births, Apgar scores, and newborn intensive care unit (NICU) admission.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectbirth outcomesen_US
dc.subjectdeliveryen_US
dc.subjectprovidersen_US
dc.subjecthospitalen_US
dc.subjectpatient characteristicsen_US
thesis.degree.namePhDen_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineNursingen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorEffken, Judith A.en_US
dc.contributor.chairEffken, Judith A.en_US
dc.contributor.committeememberJones, Elaine G.en_US
dc.contributor.committeememberBerg, Judithen_US
dc.contributor.committeememberGoldsmith, Melissaen_US
dc.identifier.proquest2646en_US
dc.identifier.oclc659749646en_US
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