Mode of birth and social inequalities in health: the effect of maternal education and access to hospital care on cesarean delivery
| Autor: | Anita Kottwitz |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
medicine.medical_specialty Health (social science) Inequality media_common.quotation_subject Geography Planning and Development Logistic regression Health Services Accessibility German Nursing Pregnancy Germany Health care Medicine Humans Social inequality Cesarean delivery media_common business.industry Cesarean Section Public Health Environmental and Occupational Health Health Status Disparities Delivery Obstetric language.human_language Hospital care Maternal education Socioeconomic Factors Family medicine language Geographic Information Systems Educational Status Female business |
| Zdroj: | Healthplace. 27 |
| ISSN: | 1873-2054 |
| Popis: | Access to health care is an important factor in explaining health inequalities. This study focuses on the issue of access to health care as a driving force behind the social discrepancies in cesarean delivery using data from 707 newborn children in the 2006–2011 birth cohorts of the German Socio-Economic Panel Study (SOEP). Data on individual birth outcomes are linked to hospital data using extracts of the quality assessment reports of nearly all German hospitals. Geographic Information Systems (GIS) are used to assess hospital service clusters within a 20-km radius buffer around mother׳s homes. Logistic regression models adjusting for maternal characteristics indicate that the likelihood to deliver by a cesarean section increases for the least educated women when they face constraints with regard to access to hospital care. No differences between the education groups are observed when access to obstetric care is high, thus a high access to hospital care seems to balance out health inequalities that are related to differences in education. The results emphasize the importance of focusing on unequal access to hospital care in explaining differences in birth outcomes. |
| Databáze: | OpenAIRE |
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