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Caesarean Section Versus Normal Vaginal Delivery: A Game Theory Discussion in Reimbursement Interventions



Mohammadshahi M1 ; Hematyar H1 ; Najafi M1 ; Alipouri Sakha M1 ; Pourreza A1
Authors
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Authors Affiliations
  1. 1. Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Source: Iranian Journal of Public Health Published:2018

Abstract

Background: The rate of caesarean section (C-section) in Iran is too high, so having a plan to control it is crucial. Since one of the most important reasons for inclination of providers to do C-section is financial issues, the purpose of this study was offering financial solutions for increasing normal vaginal delivery (NVD) and decreasing non-indicated C-section. Methods: This analytical-descriptive research, used game theory for offering financial mechanisms. The game was a dynamic one in which the backward induction was used to obtain a Nash equilibrium. Financial structure and the mean number of NVD and C-section in a certain period of time in comparison with standards were as the main influential factors on financial dimensions and were included in the model. Results: The effect of financial structure was shown through a specified insurance for childbirth, existence of a monitoring department and tariffs. Conclusion: The main solution for controlling C-section in designed game was taxes and fines for physician or hospital in non-indicated cases and giving reward otherwise. © 2018, Iranian Journal of Public Health. All rights reserved.