Caesarean Section versus Normal Vaginal Delivery: A Game Theory Discussion in Reimbursement Interventions
-
Marita MOHAMMADSHAHI
,
Hasan HEMATYAR
,
Masoumeh NAJAFI
,
Minoo ALIPOURI SAKHA
,
Abolghasem POURREZA
Abstract
Background: The rate of caesarean section (C-section) in Iran is too high, so having a plan to control it is crucial. Since one of the most important reasons for inclination of providers to do C-section is financial issues, the purpose of this study was offering financial solutions for increasing normal vaginal delivery (NVD) and decreasing non-indicated C-section.
Methods: This analytical-descriptive research, used game theory for offering financial mechanisms. The game was a dynamic one in which the backward induction was used to obtain a Nash equilibrium. Financial structure and the mean number of NVD and C-section in a certain period of time in comparison with standards were as the main influential factors on financial dimensions and were included in the model.
Results: The effect of financial structure was shown through a specified insurance for childbirth, existence of a monitoring department and tariffs.
Conclusion: The main solution for controlling C-section in designed game was taxes and fines for physician or hospital in non- indicated cases and giving reward otherwise.
1. Hosseini SA, Piroozi B, Amerzade M et al (2017). Determining the Amount of Subsidy Allocated to the Natural Childbirth Promotion Package in Health Transformation Plan and the Cesarean Section Rate in Kurdistan Province: A Brief Report. J Obstet Gynecol Cancer Res, In Press(In Press):e11209.
2. Naseh N, Khazaie T, Kianfar S, Dehghan R, Yoosefi S (2010). Prevalence of Cesarean and its complications in women referring to Vali-e-Asr hospital. Mod Care J, 7(1-2): 12-18.
3. Khan MN, Islam MM, Shariff AA et al (2017). Socio-demographic predictors and average annual rates of caesarean section in Bangladesh between 2004 and 2014. PLoS One, 12(5):e0177579.
4. Mahmoodi M, Moghimbeigi A, Faradmal J, Ghahramani M (2016). Detecting Rates, Trends and Determinants of Cesarean Section Deliveries in Iran Using Generalized Additive Mixed Models. Epidemiol Biostat Public Health,13(3): e11821-7.
5. Gibbons L, Belizán JM, Lauer JA et al (2010). The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World Health Report, 30.
6. Allen VM, O'connell CM, Farrell SA, Baskett TF (2005). Economic implications of method of delivery. Am J Obstet Gynecol, 193(1):192-7.
7. Arab M (2001). Compare of costs and effects of cesarean section and vaginal delivery after cesarean section. Avicenna Journal of Clinical Medicine, 8(2): 29-33.[In persian].
8. Davari M, Maracy M, Ghorashi Z, Mokhtari M (2014). The Relationship Between Socioeconomic Status and the Prevalence of Elective Cesarean Section in Nulliparous Women in Niknafs Teaching Centre in Rafsanjan, Iran. Womens Health Bull, 1(2): e20044.
9. Kayongo M, Rubardt M, Butera J et al (2006). Making EmOC a reality—CARE's experiences in areas of high maternal mortality in Africa. Int J Gynaecol Obstet, 92(3):308-19.
10. Berghella V, Baxter JK, Chauhan SP (2005). Evidence-based surgery for cesarean delivery. Am J Obstet Gynecol, 193(5):1607-17.
11. Notzon FC, Cnattingius S, Bergsjø P et al (1994). Cesarean section delivery in the 1980's: International comparison by indication. Am J Obstet Gynecol, 170(2):495-504.
12. Rooeintan F, Borzabad PA, Yazdanpanah A (2016). The Impact of Healthcare Reform Plan on the Rate of Vaginal Delivery and Cesarean Section in Shiraz (Iran) in 2015. Electron Physician, 8(10):3076-3080.
13. Shariat M, Majlesi F, Azari S, Mahmoudi M (2002). Cesaren section in maternity hospitals intehran, iran. Payesh, 1(3):5-10. [In persian].
14. Ramazani F (2013). Decreasing cesarean section in Iran. Tehran, Iran: MOHME. [A report in persian].
15. Chen C-S, Liu T-C, Chen B, Lin C-L (2014). The failure of financial incentive? The seemingly inexorable rise of cesarean section. Soc Sci Med, 101:47-51.
16. Rice PL, Naksook C (1998). Caesarean or vaginal birth: Perceptions and experience of Thai women in Australian hospitals. Aust N Z J Public Health, 22(5):604-8.
17. Dixit AK, Nalebuff B (2008). The art of strategy: a game theorist's guide to success in business & life. 4th ed, Norton & Company Inc. Audible Studios, pp. 152-183.
18. Brandenburger AM, Nalebuff BJ (1995). The right game: Use game theory to shape strategy. 1st ed, Harvard Business Review, pp. 57-71.
19. Osborne MJ, Rubinstein A (1994). A course in game theory. 1st MIT press, Cambridge, Massachusetts, pp. 177-195.
20. Khunpradit S, Tavender E, Lumbiganon P et al (2011). Non‐clinical interventions for reducing unnecessary caesarean section. Cochrane Database Syst Rev, (6): CD005528.
21. Hsia RY, Antwi YA, Weber E (2014). Analysis of variation in charges and prices paid for vaginal and caesarean section births: a cross-sectional study. BMJ Open, 4:e004017.
22. Folić MM, Janković SM, Folić MD, Varjačić MR (2009). Costs of caesarean section and vaginal delivery in an upper-middle-income country: a case series. Ser J Exp Clin Res, 10(2):61-4.
23. Arrieta A (2015). Over-utilization of cesarean sections and misclassification error. Health Serv Outcomes Res Methodol, 15(1):54-67.
24. Triunfo P, Rossi M (2009). The effect of physicians’ remuneration system on the Caesarean section rate: the Uruguayan case. Int J Health Care Finance Econ, 9(4):333-45.
25. Runmei M, Terence T, Yonghu S et al (2012). Practice audits to reduce caesareans in a tertiary referral hospital in south-western China. Bull World Health Organ, 90(7):488- 94.
2. Naseh N, Khazaie T, Kianfar S, Dehghan R, Yoosefi S (2010). Prevalence of Cesarean and its complications in women referring to Vali-e-Asr hospital. Mod Care J, 7(1-2): 12-18.
3. Khan MN, Islam MM, Shariff AA et al (2017). Socio-demographic predictors and average annual rates of caesarean section in Bangladesh between 2004 and 2014. PLoS One, 12(5):e0177579.
4. Mahmoodi M, Moghimbeigi A, Faradmal J, Ghahramani M (2016). Detecting Rates, Trends and Determinants of Cesarean Section Deliveries in Iran Using Generalized Additive Mixed Models. Epidemiol Biostat Public Health,13(3): e11821-7.
5. Gibbons L, Belizán JM, Lauer JA et al (2010). The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage. World Health Report, 30.
6. Allen VM, O'connell CM, Farrell SA, Baskett TF (2005). Economic implications of method of delivery. Am J Obstet Gynecol, 193(1):192-7.
7. Arab M (2001). Compare of costs and effects of cesarean section and vaginal delivery after cesarean section. Avicenna Journal of Clinical Medicine, 8(2): 29-33.[In persian].
8. Davari M, Maracy M, Ghorashi Z, Mokhtari M (2014). The Relationship Between Socioeconomic Status and the Prevalence of Elective Cesarean Section in Nulliparous Women in Niknafs Teaching Centre in Rafsanjan, Iran. Womens Health Bull, 1(2): e20044.
9. Kayongo M, Rubardt M, Butera J et al (2006). Making EmOC a reality—CARE's experiences in areas of high maternal mortality in Africa. Int J Gynaecol Obstet, 92(3):308-19.
10. Berghella V, Baxter JK, Chauhan SP (2005). Evidence-based surgery for cesarean delivery. Am J Obstet Gynecol, 193(5):1607-17.
11. Notzon FC, Cnattingius S, Bergsjø P et al (1994). Cesarean section delivery in the 1980's: International comparison by indication. Am J Obstet Gynecol, 170(2):495-504.
12. Rooeintan F, Borzabad PA, Yazdanpanah A (2016). The Impact of Healthcare Reform Plan on the Rate of Vaginal Delivery and Cesarean Section in Shiraz (Iran) in 2015. Electron Physician, 8(10):3076-3080.
13. Shariat M, Majlesi F, Azari S, Mahmoudi M (2002). Cesaren section in maternity hospitals intehran, iran. Payesh, 1(3):5-10. [In persian].
14. Ramazani F (2013). Decreasing cesarean section in Iran. Tehran, Iran: MOHME. [A report in persian].
15. Chen C-S, Liu T-C, Chen B, Lin C-L (2014). The failure of financial incentive? The seemingly inexorable rise of cesarean section. Soc Sci Med, 101:47-51.
16. Rice PL, Naksook C (1998). Caesarean or vaginal birth: Perceptions and experience of Thai women in Australian hospitals. Aust N Z J Public Health, 22(5):604-8.
17. Dixit AK, Nalebuff B (2008). The art of strategy: a game theorist's guide to success in business & life. 4th ed, Norton & Company Inc. Audible Studios, pp. 152-183.
18. Brandenburger AM, Nalebuff BJ (1995). The right game: Use game theory to shape strategy. 1st ed, Harvard Business Review, pp. 57-71.
19. Osborne MJ, Rubinstein A (1994). A course in game theory. 1st MIT press, Cambridge, Massachusetts, pp. 177-195.
20. Khunpradit S, Tavender E, Lumbiganon P et al (2011). Non‐clinical interventions for reducing unnecessary caesarean section. Cochrane Database Syst Rev, (6): CD005528.
21. Hsia RY, Antwi YA, Weber E (2014). Analysis of variation in charges and prices paid for vaginal and caesarean section births: a cross-sectional study. BMJ Open, 4:e004017.
22. Folić MM, Janković SM, Folić MD, Varjačić MR (2009). Costs of caesarean section and vaginal delivery in an upper-middle-income country: a case series. Ser J Exp Clin Res, 10(2):61-4.
23. Arrieta A (2015). Over-utilization of cesarean sections and misclassification error. Health Serv Outcomes Res Methodol, 15(1):54-67.
24. Triunfo P, Rossi M (2009). The effect of physicians’ remuneration system on the Caesarean section rate: the Uruguayan case. Int J Health Care Finance Econ, 9(4):333-45.
25. Runmei M, Terence T, Yonghu S et al (2012). Practice audits to reduce caesareans in a tertiary referral hospital in south-western China. Bull World Health Organ, 90(7):488- 94.
| Files | ||
| Issue | Vol 47 No 11 (2018) | |
| Section | Original Article(s) | |
| Keywords | ||
| Caesarian section Normal vaginal delivery Game theory Insurance | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
MOHAMMADSHAHI M, HEMATYAR H, NAJAFI M, ALIPOURI SAKHA M, POURREZA A. Caesarean Section versus Normal Vaginal Delivery: A Game Theory Discussion in Reimbursement Interventions. Iran J Public Health. 2018;47(11):1709-1716.
