The purpose of this study is to examine practice patterns for deliveries in rural hospitals, with a focus on cesarean section (c-section) rates, which are rising nationally. The diffusion of best practices may be slower to reach rural communities, and consequently, patterns of delivery may be different. Additionally, there may be non-medical issues that affect rates in rural areas, such as lack of surgical coverage on weekends. Since c-sections are more costly than vaginal births, the number of c-sections in financially challenged rural hospitals, where obstetric departments are not typically revenue generators, becomes a cost concern.

The 2000 Nationwide Inpatient Sample will be used to identify the number of deliveries performed in the sample hospitals. The proportion of deliveries that are c-section for each hospital will be calculated as well as an aggregate rate for all rural hospitals and all urban hospitals. C-section rates for rural hospitals of varying size will also be compared to urban hospitals of varying size and teaching status. Findings will be presented in a working paper and a findings brief.

Publications

• Cesarean Section Patterns in Rural Hospitals
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 11/2004
  This paper examines childbirth delivery patterns in rural hospitals and compares the cesarean section rate in rural hospitals to that in urban hospitals.
• Cesarean Section Rates in Rural Hospitals
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 03/2005
  This findings brief examines childbirth delivery patterns in rural hospitals and compares the C-section rate in rural hospitals to that in urban hospitals using the Nationwide Inpatient Sample.