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1 Dr Ganga Ganesan is a Clinical Performance Officer with the Clinical Quality Branch, MOH.

2 The Caesarean Section rates are not adjusted for clinical factors that may substantially account for the differences in rates between hospitals, i.e., prior Caesarean Section, birth order, breech presentation, placental or cord complications, sexually transmitted diseases, infections, and birth weight. Guide to inpatient quality indicators: Quality of care in hospitals – Volume, mortality, and utilization. AHRQ Pub. No. 02-R0204, Revision 3 (21 July 2004), p. 66.

3 The National Sentinel Caesarean Section Audit. Royal College of Obstetricians and Gynaecologists (RCOG)

4 OECD Health Data 2004, 1st edition. www.irdes.fr/ecosante/OECD/362000.html

5 US News & World Report, Aug 5, 2002, p.42.

6 Clinical Guideline: Caesarean Section. National Institute for Clinical Excellence. April 2004.

7 The same study showed no difference in terms of maternal mortality or serious maternal morbidity. Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomized multicentre trial. The Lancet, 2000; Vol 356: p 1375-83

8 50th Percentile Bill Size: 50% of patients pay this amount or less, 50% pay more. This figure provides an estimate of the typical bill sizes for patients.

Source: MOH Information Paper 2004/06