TY - JOUR
T1 - Cesarean delivery rates vary tenfold among US hospitals; Reducing variation may address quality and cost issues
AU - Kozhimannil, Katy Backes
AU - Law, Michael R.
AU - Virnig, Beth A.
PY - 2013/3
Y1 - 2013/3
N2 - Cesarean delivery is the most commonly performed surgical procedure in the United States, and cesarean rates are increasing. Working with 2009 data from 593 US hospitals nationwide, we found that cesarean rates varied tenfold across hospitals, from 7.1 percent to 69.9 percent. Even for women with lower-risk pregnancies, in which more limited variation might be expected, cesarean rates varied fifteenfold, from 2.4 percent to 36.5 percent. Thus, vast differences in practice patterns are likely to be driving the costly overuse of cesarean delivery in many US hospitals. Because Medicaid pays for nearly half of US births, government efforts to decrease variation are warranted. We focus on four promising directions for reducing these variations, including better coordinating maternity care, collecting and measuring more data, tying Medicaid payment to quality improvement, and enhancing patient-centered decision making through public reporting.
AB - Cesarean delivery is the most commonly performed surgical procedure in the United States, and cesarean rates are increasing. Working with 2009 data from 593 US hospitals nationwide, we found that cesarean rates varied tenfold across hospitals, from 7.1 percent to 69.9 percent. Even for women with lower-risk pregnancies, in which more limited variation might be expected, cesarean rates varied fifteenfold, from 2.4 percent to 36.5 percent. Thus, vast differences in practice patterns are likely to be driving the costly overuse of cesarean delivery in many US hospitals. Because Medicaid pays for nearly half of US births, government efforts to decrease variation are warranted. We focus on four promising directions for reducing these variations, including better coordinating maternity care, collecting and measuring more data, tying Medicaid payment to quality improvement, and enhancing patient-centered decision making through public reporting.
UR - http://www.scopus.com/inward/record.url?scp=84875014256&partnerID=8YFLogxK
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U2 - 10.1377/hlthaff.2012.1030
DO - 10.1377/hlthaff.2012.1030
M3 - Article
C2 - 23459732
AN - SCOPUS:84875014256
SN - 0278-2715
VL - 32
SP - 527
EP - 535
JO - Health Affairs
JF - Health Affairs
IS - 3
ER -