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- W2912011125 abstract "espanolObjetivo: evaluar la efectividad de una estrategia dirigida a mejorar la adecuacion de las indicaciones de cesareas en 41 hospitales del Sistema Nacional de Salud. Metodos: implantacion de un protocolo de las indicaciones de cesareas urgentes y programadas, el analisis prospectivo de su adecuacion, retroalimentar a los profesionales, impartir cursos de formacion, asignar recursos necesarios y difundir los resultados. Se utilizo un diseno pre-post sin grupo control. Resultados: el numero de partos en los periodos pre y post fue 23.711 y 29.627, y el de cesareas, 5.380 y 6.371, respectivamente. El porcentaje global de cesareas descendio 1,19, y el de adecuacion global aumento 15,45 (IC 95%: 13,78–17,13); 8,65 (IC 95%: 6,24-11,07) en el conjunto de programadas y, 20,15 (IC 95%:17,93- 22,36) en el conjunto de las urgentes. La mejora en la adecuacion se observo en las cinco indicaciones de cesareas urgentes y oscilo entre 10,87 (IC 95%: 6,85–14,89) en el grupo de riesgo de perdida de bienestar fetal y 29,97 (IC 95%: 24,49-35,45) en el de desproporcion pelvifetal. Conclusion: esta estrategia parece ser efectiva para aumentar la adecuacion de las indicaciones de cesareas y reducir las complicaciones y los costes asociados con las cesareas evitadas. EnglishBackground: We evaluated the effectiveness of a multifaceted strategy to improve the appropriateness of the indications for cesarean delivery in 41 hospitals belonging to the Spanish National Health Service. Methods: We implemented indications for emergency and elective cesareans and analyzed their appropriateness prospectively. We provided staff with feedback and training courses and allocated the necessary resources. The results were published. A pre-post design without a control group was used. Results: The total number of deliveries in both periods was 23,711 and 29,627; of these, 5,380 and 6,371, respectively, were cesarean deliveries. The general cesarean rate decreased by 1.19 percentage points, and the overall appropriateness rate increased by 15.45% (95%CI, 13.78-17.13): 8.65% (95%CI, 6.24-11.07) for elective cesarean and 20.15% (95%CI, 17.93-22.36) for emergency cesareans. Appropriateness improved across all 5 indications for emergency cesarean, ranging from 10.87% (95%CI, 6.85-14.89) for fetal distress to 29.97% (95%CI, 24.49-35.45) for cephalopelvic disproportion. Conclusion: This strategy appears to be effective for increasing the appropriateness of the indications for cesarean delivery and reducing the complications and costs associated with the cesarean deliveries avoided." @default.
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- W2912011125 date "2018-01-01" @default.
- W2912011125 modified "2023-10-18" @default.
- W2912011125 title "A multifaceted model for improving the appropriateness of indications for cesarean delivery" @default.
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