Exploring Factors Associated with Cesarean Section Deliveries in the United States: An Analysis of the National Inpatient Sample, 2017

Abstract

Experts in maternal health have long noted that the United States has a high rate of cesarean section utilization for maternity patients. This thesis uses the 2017 National Inpatient Sample (NIS) to assess the impact of patient, hospital, and area-level factors on all cesarean section deliveries, and, only on those without complications. As policy makers, payers, patients, clinicians, and other stakeholders interested in safely reducing cesarean section rates consider interventions, it is important for them to understand the factors associated with cesarean section deliveries. This thesis finds that there are associations between cesarean section delivery rates and patient, hospital, and area-level factors. This thesis finds sizable variation in cesarean section rates across race cohorts and their expected primary payers. This thesis also finds higher proportions of cesarean section deliveries in for-profit hospitals than public or non-profit hospitals, which could be due in part to the patient mix and different financial motivations at these hospitals.