• Int J Qual Health Care · Feb 2018

    The impact of health sector evolution plan on hospitalization and cesarean section rates in Iran: an interrupted time series analysis.

    • Behzad Karami Matin, Mohammad Hajizadeh, Farid Najafi, Enayatollah Homaie Rad, Bakhtiar Piroozi, and Satar Rezaei.
    • Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
    • Int J Qual Health Care. 2018 Feb 1; 30 (1): 75-79.

    ObjectiveTo investigate the effect of the health sector evolution plan (HSEP) on hospitalization and cesarean section (C-section) rates in Kermanshah province in the western region of Iran.DesignInterrupted time series analysis.SettingHospital care system in Kermanshah province.Study ParticipantsFifteen hospitals affiliated to Ministry of Health and Medical Education (MoHME) in Kermanshah province.Intervention(S)Health sector evolution plan.Main Outcome MeasuresHospitalization rate and C-section rate.ResultsWe observed a statistically significant increase in the hospitalization rate (12.9 hospitalizations per 10 000 population, P < 0.001) in the first month after the implementation of the HSEP. Compared with the monthly trend in hospitalization rate before the intervention, we found a significant increase of 0.70 hospitalizations per 10 000 population (P < 0.001) in monthly trend in hospitalization rate after the HSEP. Although the proportion of C-section from total deliveries decreased by 11% (P = 0.044) in the first month after the implementation of the HSEP, the proportion of C-section from total deliveries increased at the rate of 0.0017% (P = 0.001) per month during post-intervention period.ConclusionWe found an increase in the hospitalization rate after the intervention of HSEP. Although the C-section rate in the first month after the HSEP decreased, we observed an increasing trend in C-section rate over the study period; this implies that the HSEP did not promote vaginal delivery in Iran, which is outlined as one of the objectives of the intervention.© The Author(s) 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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