Nighttime call in house vs. out of house: a comparison of obstetric procedure rates

J Reprod Med. 2004 Mar;49(3):143-7.

Abstract

Objective: To evaluate the effect of in-house vs. out-of-house nighttime call coverage on obstetric practice.

Study design: A retrospective analysis was performed on nighttime deliveries. Included were deliveries by 2 faculty groups that equally shared in-house and out-of-house call coverage. Included patients had an equal chance of delivering with a physician on call covering in house or out of house. Patient demographics and obstetric outcomes were compared between in-house and out-of-house call status for the delivering physician by ANOVA and chi2.

Results: Of eligible nighttime deliveries, 230 were identified, 120 with in-house and 110 with out-of-house call coverage. Demographic features were not statistically different between the groups. A comparison of in-house and out-of-house deliveries yielded rates for episiotomy (28.3% vs. 30.0%), cesarean delivery (26.7% vs. 21.8%), operative vaginal delivery (11.7% vs. 18.2%), total operative delivery (38.4% vs. 40.0%) and nonoperative vaginal delivery (61.7% vs. 60.0%) that did not significantly differ by physician call status.

Conclusion: The nighttime call status of physicians, whether in house or out of house, did not affect cesarean delivery, operative vaginal delivery, overall (total) operative delivery or episiotomy rates.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • After-Hours Care / statistics & numerical data*
  • Cesarean Section / statistics & numerical data
  • Delivery, Obstetric / methods*
  • Delivery, Obstetric / statistics & numerical data
  • Episiotomy / statistics & numerical data
  • Female
  • Hospitals, University
  • Humans
  • Medical Staff, Hospital
  • Night Care
  • Obstetrics / statistics & numerical data*
  • Obstetrics and Gynecology Department, Hospital* / statistics & numerical data
  • Philadelphia / epidemiology
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Pregnancy
  • Retrospective Studies
  • Workforce
  • Workload / statistics & numerical data