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Indicator Metadata

NameCaesarean Section Rate
Short/Other Names

C-Section Rate

Description

This indicator measures the crude rate of all Caesarean sections (C-sections) per 100 deliveries.

For further details, please see the General Methodology Notes.

InterpretationLower rates are desirable.
HSP Framework Dimension

Health System Outputs: Appropriate and effective

Areas of Need

Getting Better

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory, Region

Indicator Results

http://yourhealthsystem.cihi.ca/epub/?language=en

Identifying Information
NameCaesarean Section Rate
Short/Other Names

C-Section Rate

Indicator Description and Calculation
Description

This indicator measures the crude rate of all Caesarean sections (C-sections) per 100 deliveries.

For further details, please see the General Methodology Notes.

Calculation: Description

The indicator is expressed as the rate of C-sections per 100 deliveries.

(Number of C-sections ÷ Number of deliveries) × 100

Unit of analysis: Single admission

Calculation: Geographic Assignment

Place of residence

Calculation: Type of Measurement

Rate - per 100

Calculation: Adjustment Applied

None

Calculation: Method of Adjustment

Not applicable

Denominator

Description:
Hospitalizations where a delivery was recorded
Inclusions:
1. Admission to an acute care institution (Facility Type Code = 1)

2. Sex recorded as female

3. Delivery coded in any diagnosis field:

ICD-10-CA

O10–O16, O21–O29, O30–O37, O40–O46, O48, O60–O69, O70–O75, O85–O89, O90–O92, O95, O98, O99 with a sixth digit of 1 or 2; or Z37
Exclusions:
1. Newborn, stillbirth or cadaveric donor records (Admission Category = N, R or S)

2. Delivery in which an abortive procedure was recorded (code may be recorded in any position; procedures coded as out of hospital or abandoned after onset [OOH Indicator Flag = Y or Intervention Status Attribute = A] are excluded):

CCI:

5.CA.20.^^, 5.CA.24.^^, 5.CA.88.^^, 5.CA.89.^^, or 5.CA.93.^^

OR

ICD-10-CA:

O04

Numerator

Description:
Cases within the denominator where a C-section delivery was recorded
Inclusions:
The numerator is a subset of the denominator. C-section is identified as any of the following procedure codes (code may be recorded in any position; procedures coded as out of hospital and abandoned after onset are excluded):

CCI

5.MD.60^^

Background, Interpretation and Benchmarks
Rationale

C-section rates provide information on the frequency of surgical birth delivery relative to all modes of birth delivery. Since C-section delivery increases maternal morbidity/mortality and is associated with higher costs, C-section rates are often used to monitor clinical practices, with an implicit assumption that lower rates indicate more appropriate, as well as more efficient, care.

Interpretation

Lower rates are desirable.

HSP Framework Dimension

Health System Outputs: Appropriate and effective

Areas of Need

Getting Better

Targets/Benchmarks

Not applicable

References

Canadian Institute for Health Information. Giving Birth in Canada: A Regional Profile. Ottawa, ON: CIHI; 2004.

Canadian Institute for Health Information. Giving Birth in Canada: Regional Trends From 2001-2002 to 2005-2006. Ottawa, ON: CIHI; 2007.

Joseph KS, Kramer MS, Marcoux S, et al. Determinants of Pre-Term Birth Rates in Canada From 1981 Through 1983 and From 1992 Through 1994. N Engl J Med. 1998; 339:1434-1439.

Liu S, Rusen ID, Joseph KS, et al. Recent Trends in Caesarean Delivery Rates and Indications for Caesarean Delivery in Canada. Journal of Obstetrics and Gynaecology Canada. 2004;26(8):735-742.

Liu S, Heaman M, Joseph KS, et al. Risk of Maternal Postpartum Readmission Associated With Mode of Delivery. Obstetrics and Gynecology. 2005;105(4):836-842.pp. 836-842.

National Collaborating Centre for Women's and Children's Health. Caesarean Section [clinical practice guideline]. 2011 rev ed. London, U.K.: RCOG Press; 2012. www.nice.org.uk/nicemedia/live/13620/57162/57162.pdf.

Shearer EL. Cesarean Section: Medical Benefits and Costs. Social Science & Medicine. 1993;37:1223-1231.

Availability of Data Sources and Results
Data Sources

DAD, HMDB

Available Data Years

Type of Year:
Fiscal
First Available Year:
1997
Last Available Year:
2015

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory, Region

Result Updates
Update Frequency

Every year

Indicator Results

Web Tool:
Health Indicators E-publication
URL: http://yourhealthsystem.cihi.ca/epub/?language=en

Updates

Not applicable

Quality Statement
Caveats and Limitations

Not applicable

Trending Issues

Not applicable

Comments

Caesarean Section Rate is also known as Total C-Section Rate in CIHI's Quick Stats product, under DAD/HMDB Childbirth Indicators by Place of Residence (2013–2014 results released March 2015).

This Quick Stats product provides 14 childbirth indicators reported at the national, provincial/territorial and regional levels.

Indicator results and full methodological notes can be found here:

http://apps.cihi.ca/mstrapp/asp/Main.aspx?Server=apmstrextprd_i&project=Quick+Stats&uid=pce_pub_en&pwd=&evt=2048001&visualizationMode=0&documentID=029DB170438205AEBCC75B8673CCE822