Birth Complication Rates Vary Widely By Hospital

Main Category: Pregnancy / Obstetrics
Also Included In: Women's Health / Gynecology;  Clinical Trials / Drug Trials;  Public Health
Article Date: 30 Jun 2010 - 2:00 PDT

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Complication rates for vaginal and C-section deliveries can vary widely from one hospital to the next according to a study released by HealthGrades, the leading independent health care ratings organization.

The study found that best-performing hospitals had, on average, 51% fewer maternal complications among women who had vaginal births, when compared to poor-performing hospitals. These same hospitals had 74% fewer complications among women who had C-sections when compared to poor performers. The study also found that C-section rates averaged 32.6% at the 1,546 hospitals studied.

"The HealthGrades study shows that hospitals can differ dramatically in terms of maternity outcomes, even as complication rates overall continue to decline over time," said Rick May, MD, a vice president with HealthGrades and co-author of the study. "The good news for women and their families is that objective data exists to help them understand this variation and find the best hospital in which to deliver their baby."

As part of the study, HealthGrades rated each of 1,546 hospitals in 19 states with a 1, 3 or 5-star rating based on four factors:

-- Maternal complication rate among women undergoing single live-born vaginal or C-section deliveries

-- Maternal complication rate among women undergoing "patient-choice" or non-clinically indicated C-sections

-- Newborn volume adjusted for low birth weight

-- Newborn mortality rate stratified into eight birth weight categories

Hospitals receiving a 5-star rating were among the top 15% of hospitals in the 19 states studied. Comparing these 5-star hospitals to 1-star rated hospitals, those in the bottom 15% of hospitals studied, the study concluded that:

-- Top-performing hospitals had fewer complications compared with poor-performing hospitals, with 51.3% fewer maternal complications for vaginal births, 74.3% fewer maternal complications for C-sections and 84.1% fewer complications for patient-choice C-sections.

-- If all hospitals in the 19 states studied performed at the level of the best-performing hospitals from 2006 through 2008, 176,654 women may have avoided one or more inhospital major obstetric complications.

-- Top-performing hospitals had a 57.1% lower weight-stratified neonatal mortality compared to poor-performing hospitals, and a 35.2% lower mortality than average-performing hospitals.

-- Top-performing hospitals had the highest episiotomy rates and vacuum-assisted delivery rates but the lowest forceps-assisted delivery rates.

Hospitals rated with 5 stars by HealthGrades for their maternity care outcomes tended to have much higher delivery volume. On average, 5-star rated hospitals delivered 7,029 babies over the three years studied, compared to an average of 4,346 and 1,702 for 3-star and 1-star rated hospitals, respectively.

Hospitals ranked in the top 10% of all hospitals studied received the HealthGrades 2010/2011 Maternity Care Excellence Award.

The annual study analyzed 14 million hospital records obtained through the following 19 state governments: Arizona, California, Colorado, Florida, Iowa, Maine, Maryland, Massachusetts, New Jersey, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Virginia, Washington and Wisconsin.

About HealthGrades

Health Grades, Inc. (Nasdaq: HGRD) is the leading independent healthcare ratings organization, providing quality ratings, profiles and cost information on the nation's hospitals, physicians, nursing homes and prescription drugs. Millions of patients and many of the nation's largest employers, health plans and hospitals rely on HealthGrades' quality ratings, advisory services and decision-support resources. The HealthGrades Network of Web sites, including HealthGrades.com and WrongDiagnosis.com, is a top-five health property according to ComScore and is the Internet's leading destination for patients choosing providers.

Source: HealthGrades

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