Author/Authors :
Ostovar, Rahim yasuj university of medical sciences - School of Health - Department of Public Health, ايران , Pourreza, Abolghasem tehran university of medical sciences tums - School of Public Health - Department of Health Managementand Economics, تهران, ايران , Rashidian, Arash tehran university of medical sciences tums - School of Public Health - Department of Health Managementand Economics, تهران, ايران , Rashidian, Arash tehran university of medical sciences tums - Knowledge Translation Research Center, تهران, ايران , Hossein Rashidi, Batool tehran university of medical sciences tums - Faculty of Medicine - Vali-e-Asr Reproductive Health Research Center, تهران, ايران , Hantooshzadeh, Sedigheh tehran university of medical sciences tums - Faculty of Medicine - Vali-e-Asr Reproductive Health Research Center, تهران, ايران , Haghollai, Fedyeh tehran university of medical sciences tums - Faculty of Medicine - Vali-e-Asr Reproductive Health Research Center, تهران, ايران , Eftekhar Ardebili, Hasan tehran university of medical sciences tums - School of Public Health - Department of Health Improvement, تهران, ايران , Mahmoudi, Mahmoud tehran university of medical sciences tums - School of Health - Department of Statistics and Epidemiology, تهران, ايران
Abstract :
Background: The aim of this study was to identify the appropriateness of cesarean sections, performed in Tehran hospitals using standardized Rand Appropriateness Method (RAM) criteria.Methods: In this study we used the RAM criteria. In order to prepare the list of cesarean scenarios, clinical guidelines were selected, and the Appraisal of Guidelines for Research and Evaluation was used to choose the most appropriate. Two panels were held with the participation of related specialists. The scenarios derived through this method were compared with data existing in the medical records of 250 women who underwent cesarean sections in selected hospitals affiliated with Tehran University of Medical Sciences. The appropriateness rate of the cesarean sections was calculated.Results: Out of 250 cases of cesarean sections performed, 91 (36.4%) were inappropriate, 41 (16.4%) were equivocal and 118 (47.2%) were considered to be appropriate. Appropriateness differed between public and private hospitals, which were statistically significant.Conclusion: This study shows that as with many other health services, cesarean section has many scenarios that there are different opinions about them and no decision about presenting these scenarios as yet. Moreover the result of study showed the rate of inappropriate cesarean sections in this study is one of the highest reported rates from different communities.
