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Changes in the cesarean section rate in Korea (1982-2012) and a review of the associated factors.

Chung SH, Seol HJ, Choi YS, Oh SY, Kim A, Bae CW - J. Korean Med. Sci. (2014)

Bottom Line: We found that countries with a no-fault compensation system maintained a lower CSR compared to that in countries with civil action, indicating the close relationship between the CSR and the medico-legal system within a country.The Korean government has implemented strategies including an incentive system relating to the CSR or encouraging vaginal birth after Cesarean to decrease CSR, but such strategies have proved ineffective.And from a national view point, reforming health care system, which could encourage the experienced obstetricians to be trained properly and be relieved from legal pressure with deliveries is necessary.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea.

ABSTRACT
Although Cesarean section (CS) itself has contributed to the reduction in maternal and perinatal mortality, an undue rise in the CS rate (CSR) has been issued in Korea as well as globally. The CSR in Korea increased over the past two decades, but has remained at approximately 36% since 2006. Contributing factors associated with the CSR in Korea were an improvement in socio-economic status, a higher maternal age, a rise in multiple pregnancies, and maternal obesity. We found that countries with a no-fault compensation system maintained a lower CSR compared to that in countries with civil action, indicating the close relationship between the CSR and the medico-legal system within a country. The Korean government has implemented strategies including an incentive system relating to the CSR or encouraging vaginal birth after Cesarean to decrease CSR, but such strategies have proved ineffective. To optimize the CSR in Korea, efforts on lowering the maternal childbearing age or reducing maternal obesity are needed at individual level. And from a national view point, reforming health care system, which could encourage the experienced obstetricians to be trained properly and be relieved from legal pressure with deliveries is necessary.

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Related in: MedlinePlus

The Cesarean section rate in 2011 according to legal pressure (11, 16, 17). The following systems were considered: no-fault compensation system in Sweden, government sponsored no-fault compensation system and unitary compensation system in New Zealand, fault liability system in Japan, mistake lawsuit system in England, and civil litigation system in the USA, Australia, and Korea (Grouping by system: Group I, Sweden and New Zealand; Group IIa, Japan; Group IIb, England; Group III, USA, Australia, and Korea).
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Figure 4: The Cesarean section rate in 2011 according to legal pressure (11, 16, 17). The following systems were considered: no-fault compensation system in Sweden, government sponsored no-fault compensation system and unitary compensation system in New Zealand, fault liability system in Japan, mistake lawsuit system in England, and civil litigation system in the USA, Australia, and Korea (Grouping by system: Group I, Sweden and New Zealand; Group IIa, Japan; Group IIb, England; Group III, USA, Australia, and Korea).

Mentions: To understand the relationship between the CSR and the medico-legal system, we analyzed the correlation between the responsibility of doctors and the CSR within the medico-legal system, focusing on six OECD countries and Korea (Fig. 4) (11, 16, 17). The OECD-CS SPR in Sweden has remained stable at < 20 (12.1 in 1998 and 16.2 in 2011)-partially owing to the no-fault compensation system for legal damages. Meanwhile, the OECD-CS SPR of the United States and Australia and Korea-with civil litigation system by fault liability-is increasing gradually: 32.8 and 32.2, respectively, in 2011.


Changes in the cesarean section rate in Korea (1982-2012) and a review of the associated factors.

Chung SH, Seol HJ, Choi YS, Oh SY, Kim A, Bae CW - J. Korean Med. Sci. (2014)

The Cesarean section rate in 2011 according to legal pressure (11, 16, 17). The following systems were considered: no-fault compensation system in Sweden, government sponsored no-fault compensation system and unitary compensation system in New Zealand, fault liability system in Japan, mistake lawsuit system in England, and civil litigation system in the USA, Australia, and Korea (Grouping by system: Group I, Sweden and New Zealand; Group IIa, Japan; Group IIb, England; Group III, USA, Australia, and Korea).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214933&req=5

Figure 4: The Cesarean section rate in 2011 according to legal pressure (11, 16, 17). The following systems were considered: no-fault compensation system in Sweden, government sponsored no-fault compensation system and unitary compensation system in New Zealand, fault liability system in Japan, mistake lawsuit system in England, and civil litigation system in the USA, Australia, and Korea (Grouping by system: Group I, Sweden and New Zealand; Group IIa, Japan; Group IIb, England; Group III, USA, Australia, and Korea).
Mentions: To understand the relationship between the CSR and the medico-legal system, we analyzed the correlation between the responsibility of doctors and the CSR within the medico-legal system, focusing on six OECD countries and Korea (Fig. 4) (11, 16, 17). The OECD-CS SPR in Sweden has remained stable at < 20 (12.1 in 1998 and 16.2 in 2011)-partially owing to the no-fault compensation system for legal damages. Meanwhile, the OECD-CS SPR of the United States and Australia and Korea-with civil litigation system by fault liability-is increasing gradually: 32.8 and 32.2, respectively, in 2011.

Bottom Line: We found that countries with a no-fault compensation system maintained a lower CSR compared to that in countries with civil action, indicating the close relationship between the CSR and the medico-legal system within a country.The Korean government has implemented strategies including an incentive system relating to the CSR or encouraging vaginal birth after Cesarean to decrease CSR, but such strategies have proved ineffective.And from a national view point, reforming health care system, which could encourage the experienced obstetricians to be trained properly and be relieved from legal pressure with deliveries is necessary.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea.

ABSTRACT
Although Cesarean section (CS) itself has contributed to the reduction in maternal and perinatal mortality, an undue rise in the CS rate (CSR) has been issued in Korea as well as globally. The CSR in Korea increased over the past two decades, but has remained at approximately 36% since 2006. Contributing factors associated with the CSR in Korea were an improvement in socio-economic status, a higher maternal age, a rise in multiple pregnancies, and maternal obesity. We found that countries with a no-fault compensation system maintained a lower CSR compared to that in countries with civil action, indicating the close relationship between the CSR and the medico-legal system within a country. The Korean government has implemented strategies including an incentive system relating to the CSR or encouraging vaginal birth after Cesarean to decrease CSR, but such strategies have proved ineffective. To optimize the CSR in Korea, efforts on lowering the maternal childbearing age or reducing maternal obesity are needed at individual level. And from a national view point, reforming health care system, which could encourage the experienced obstetricians to be trained properly and be relieved from legal pressure with deliveries is necessary.

Show MeSH
Related in: MedlinePlus