Practice variation, bias, and experiential learning in cesarean delivery: a data-based system dynamics approach.

ABSTRACT:

Objectives

To simulate physician-driven dynamics of delivery mode decisions (scheduled cesarean delivery [CD] vs. vaginal delivery [VD] vs. unplanned CD after labor), and to evaluate a behavioral theory of how experiential learning leads to emerging bias toward more CD and practice variation across obstetricians.

Data sources/study setting

Hospital discharge data on deliveries performed by 300 randomly selected obstetricians in Florida who finished obstetrics residency and started practice after 1991.

Study design

We develop a system dynamics simulation model of obstetricians' delivery mode decision based on the literature of experiential learning. We calibrate the model and investigate the extent to which the model replicates the data.

Principal findings

Our l

SUBMITTER: Ghaffarzadegan N 

PROVIDER: S-EPMC3626332 | biostudies-literature | 2013 Apr

REPOSITORIES: biostudies-literature