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

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. 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. The effect of financial structure was shown through a specified insurance for childbirth, existence of a monitoring department and tariffs. 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.