Racial variations in cesarean section rates: an analysis of Medicaid data in Louisiana.

The objective of this study was to investigate racial variation in cesarean section rates among Medicaid beneficiaries in Louisiana. Results indicate that over a three-year period, white women had higher rates than women of other races when stratified by age, locality, accompanying diagnoses, and hospital ownership. Comparing Louisiana Medicaid data with birth certificate records, rates among all births were slightly higher than Medicaid births, with the same racial trend. These variations imply significant differences in costs and reimbursement to providers and raising questions about efficiency of current obstetric practices in Louisiana. Implications for a managed care system are discussed.