Setting goals for reductions in Canadian cesarean delivery rates: Benchmarking medical practice patterns, ,

Objective: The objective of this study was to present a structured method for determining achievable cesarean rate goals and specifying which hospitals should receive focused attention. Study Design: Hospital level data from the largest 239 Canadian maternity units were analyzed for 1988-1989, when the number of Canadian cesarean deliveries peaked. Cesarean rate statistical limits within the largest, intermediate-sized, and smallest maternity unit classifications were successively set at the 75th, 50th, and 25th percentiles. Results: The national impact resulting from using the 75th percentile rate as the assigned statistical cesarean rate limit was 2707 (50th 5568; 25th 11,018) fewer cesarean deliveries. Conclusion: Benchmarking provides a structured perspective on defining goals and on estimating how much change is required and at which hospitals. (Am J Obstet Gynecol 1999;181:635-7.)