Evidence-based Birth Attendance in Spain: Private versus Public Centers

Antonio Hernández-Martínez, Juan Miguel Martínez-Galiano, Julián Rodríguez-Almagro, Miguel Delgado-Rodríguez and Juan Gómez-Salgado
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Antonio Hernández-Martínez: Mancha-Centro Hospital, Alcázar de San Juan, 13600 Ciudad Real, Spain
Juan Miguel Martínez-Galiano: Department of Nursing, University of Jaén, Campus de Las Lagunillas s/n, Building B3 Office 266, 23071 Jaén, Spain
Julián Rodríguez-Almagro: Department of Nursing, University of Castilla la Mancha, 13071 Ciudad Real, Spain
Miguel Delgado-Rodríguez: Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
Juan Gómez-Salgado: Department of Nursing, Faculty of Nursing, University of Huelva, 21071 Huelva, Spain

IJERPH, 2019, vol. 16, issue 5, 1-12

Abstract: The type of hospital (public or private) has been associated with the type of clinical practice carried out. The purpose of this study was to determine the association between the type of hospital (public or private) and delivery attendance with practices based on the recommendations by the World Health Organization (WHO). A cross-sectional study with puerperal women ( n = 2906) was conducted in Spain during 2017. The crude Odds Ratios (OR), adjusted (aOR) and their 95% confidence intervals (CI) were calculated through binary logistic regression. For multiparous women in private centers, a higher rate of induced labor was observed (aOR: 1.49; 95% CI: 1.11–2.00), fewer natural methods were used to relieve pain (aOR: 0.51; 95% CI: 0.35–0.73), and increased odds of cesarean section (aOR: 2.50; 95% CI: 1.81–3.46) were found as compared to public hospitals. For primiparous women in private centers, a greater use of the epidural was observed (aOR: 1.57; 95% CI: 1.03–1.40), as well as an increased likelihood of instrumental birth (aOR: 1.53; 95% CI: 1.09–2.15) and of cesarean section (aOR: 1.77; 95% CI: 1.33–2.37) than in public hospitals. No differences were found in hospitalization times among women giving birth in public and private centers ( p > 0.05). The World Health Organization birth attendance recommendations are more strictly followed in public hospitals than in private settings.

Keywords: birth; maternal outcomes; public hospital; private hospital; care suppliers (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:16:y:2019:i:5:p:894-:d:213172

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