{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:45:41Z","timestamp":1791420341701,"version":"4.3.3"},"reference-count":23,"publisher":"American Public Health Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[1990,3]]},"abstract":"<jats:p> This study assessed the relation between payment source and cesarean section use by analyzing California data on hospital deliveries. Of 461,066 deliveries in 1986, cesarean sections were performed in 24.4 percent. Women with private insurance had the highest cesarean section rates (29.1 percent). Successively lower rates were observed for women covered by non-Kaiser health maintenance organizations (26.8 percent), Medi-Cal (22.9 percent), Kaiser (19.7 percent), self-pay (19.3 percent), and Indigent Services (15.6 percent). Vaginal birth after cesarean (VBAC) occurred more than twice as frequently in women covered by Kaiser (19.9 percent) and Indigent Services (24.8 percent), compared to those with private insurance (8.1 percent). Sizable, although less pronounced, associations between payment source and cesarean section use were noted for the indications of breech presentation, dystocia, and fetal distress. Accounting for maternal age and race\/ethnicity did not alter these findings. Variations in the use of cesarean section have a substantial financial impact on health care payors. <\/jats:p>","DOI":"10.2105\/ajph.80.3.313","type":"journal-article","created":{"date-parts":[[2008,11,29]],"date-time":"2008-11-29T13:17:08Z","timestamp":1227964628000},"page":"313-315","source":"Crossref","is-referenced-by-count":107,"title":["Cesarean section use and source of payment: an analysis of California hospital discharge abstracts."],"prefix":"10.2105","volume":"80","author":[{"given":"R S","family":"Stafford","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"p_1","unstructured":"Eisenberg JM: Doctors' Decisions and the Cost of Medical Care. Ann Arbor: Health Administration Press, 1986."},{"key":"p_2","doi-asserted-by":"publisher","DOI":"10.1038\/scientificamerican0482-120"},{"key":"p_3","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-198505000-00011"},{"key":"p_4","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-198606000-00001"},{"key":"p_5","unstructured":"Cesarean Childbirth: Report of a Consensus Development Conference\/ sponsored by the National Institute of Child Health and Human Development in conjunction with the National Center for Health Care Technology and assisted by the Office for Medical Applications in Research, Sept 22-24, 1980. NIH Pub. No. 82-2067. Bethesda, MD: US DHHS, PHS, NIH, 1982."},{"key":"p_6","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.78.5.562"},{"key":"p_7","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.78.1.96-a"},{"key":"p_8","unstructured":"Goldfarb MG: Who Receives Cesareans: Patient and Hospital Characteristics. DHHS pub. no. (PHS) 84-3345. Rockville, MD: National Center for Health Services Research, 1984."},{"key":"p_9","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.73.8.863"},{"key":"p_10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198609043151005"},{"key":"p_11","unstructured":"1986 Discharge Data Tape Format Documentation: Sacramento: California Office of Statewide Health Planning and Development, January 1986."},{"key":"p_12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198410043111405"},{"key":"p_13","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.77.8.955"},{"key":"p_14","unstructured":"Woolson RF: Statistical Methods for the Analysis of Biomedical Research. New York: Wiley, 1987."},{"key":"p_15","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(88)90224-4"},{"key":"p_16","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.78.5.512"},{"key":"p_17","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(87)90272-9"},{"key":"p_18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198907273210406"},{"key":"p_19","doi-asserted-by":"publisher","DOI":"10.2307\/2134964"},{"key":"p_20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198103263041313"},{"key":"p_21","unstructured":"Public Relations Division of the Health Insurance Association of America: The Cost of Having a Baby: Report of a Survey. Washington DC: Health Insurance Association of America, 1987."},{"key":"p_22","unstructured":"Quilligan E: Cesarean section: modern perspective. In: Queenan JT. (ed): Management of High-risk Pregnancy, 2nd ed. Oradell NJ: Medical Economics Co, Book Division, 1985."},{"key":"p_23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198812083192304"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.80.3.313","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T18:19:39Z","timestamp":1652120379000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.80.3.313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1990,3]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1990,3]]}},"alternative-id":["10.2105\/AJPH.80.3.313"],"URL":"https:\/\/doi.org\/10.2105\/ajph.80.3.313","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[1990,3]]}}}