Results of a new study on hospital quality for maternity care published in Monday’s issue of Health Affairs, a health journal, show that where a woman gives birth can make a major difference to her own health. Women who deliver in low-performing facilities suffered more than twice the rate of major complications for vaginal births, and the disparity was even greater — a fivefold difference — for Cesarean deliveries.
Without any comprehensive data base where moms-to-be can research ahead of time, it’s often difficult to determine which hospital in your area provides better care. But this new study is spurring change. Medical groups, including the American Congress of Obstetricians and Gynecologists, are working on developing a consumer-friendly data base that can tap into clinical information from electronic medical records. If you’re expecting anytime soon, however, it won’t help: Development of the system could take another three to five years.
Researchers led by Dr. Laurent Glance, a professor of anesthesiology at Rochester Medical School in New York, analyzed billing data for a national sample of more than 750,000 deliveries in 2010. They adjusted for differences in the health status of patients served by the hospitals.
For vaginal births, an average of 23 percent of women delivering at low-quality hospitals experienced a major complication, compared with 10 percent at high-quality facilities, and 15 percent at average-quality hospitals. The wider gap occurs on Cesarean births, with nearly 21percent experiencing a major complication at hospitals rated low-quality, and only 5 percent having complications at hospitals with a high-quality rating.
Since the study uses billing information, it is several steps away from clinical data and cannot give a full picture of what actually happened to the patients. New data bases in the works will use clinical data extracted from electronic medical records (with the patient’s personal information removed for privacy reasons) with an ultimate goal of providing women and their families with important information on the quality of care they can expect.