Unexplained variation in hospital caesarean section rates

Rick J Fielke
Med J Aust 2014; 200 (2): . || doi: 10.5694/mja13.11200
Published online: 3 February 2014

To the Editor: Lee and colleagues assessed the hospital caesarean section (CS) rates among hospitals in New South Wales according to the Robson 10-group classification. They identified the 20th centile CS rate for each group.1 These data could be used in Australian maternity services to reduce CS rates and potentially increase the quality of care.

  • Women’s and Children’s Hospital, Adelaide, SA.


Competing interests:

No relevant disclosures.

  • 1. Lee YY, Roberts CL, Patterson JA, et al. Unexplained variation in hospital caesarean section rates. Med J Aust 2013; 199: 348-353. <MJA full text>
  • 2. Sibanda T, Fox R, Draycott TJ, et al. Intrapartum care quality indicators: a systematic approach for achieving consensus. Eur J Obstet Gynecol Reprod Biol 2013; 166: 23-29.
  • 3. Thor J, Lundberg J, Ask J, et al. Application of statistical process control in healthcare improvement: systematic review. Qual Saf Health Care 2007; 16: 387-399.
  • 4. Boulkedid R, Alberti C, Sibony O. Quality indicator development and implementation in maternity units. Best Pract Res Clin Obstet Gynaecol 2013; 27: 609-619.
  • 5. Boulkedid R, Sibony O, Bossu-Salvador C, et al. Monitoring healthcare quality in an obstetrics and gynaecology department using a CUSUM chart. BJOG 2010; 117: 1225-1235.


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