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Poster session II Diabetes, labor, medical-surgical-disease, obstetric quality & safety, prematurity, ultrasound-imaging: Abstracts 237 – 386| Volume 206, ISSUE 1, SUPPLEMENT , S148, January 01, 2012

311: The physician factor in inductions of labor and cesarean delivery rates

      Objective

      To investigate if a physicians time in practice and type of practice (group vs. solo) has any impact on cesarean delivery (CD) rates for induced labors and if physicians with high induction rates have higher CD rates.

      Study Design

      We performed a retrospective study of 1243 singleton, cephalic, term (> 37 wks) inductions delivered by 43 obstetricians over 2 years in a tertiary center. Physicians with more than 50 deliveries per year were studied. Physician experience was measured by the number of years in practice since residency. There were 27 physicians in group practice and 16 physicians in solo practice. Patient characteristics, rates of induction and CD rates were studied in relationship to the experience of physician. Patients with previous CD were excluded. The primary outcome variable was the percent of each physicians induced labors that resulted in a CD. Analysis was performed by using Pearson correlation and logistic regression. Regression analysis was performed using physician and patient characteristics as explanatory variables for CD among the patients who were induced. Induction rates and total inductions were dichotomized based on 75th percentile (20%) and t- tests were performed.

      Results

      Of the 1243 induced patients, 364 [29 %] had a CD. Nulliparity (25.1% vs. multiparity 3.62%, p 20%, p=0.52). Physicians in group practice had lower CD rates compared to solo practitioners (p=0.04).

      Conclusion

      Our data shows that, experience and induction rates of the physician do not influence CD rates. Group practice may reduce the CD rates.