Impact of Risk-Adjusting Cesarean Delivery Rates When Reporting Hospital Performance
Open Access
- 24 June 1998
- journal article
- research article
- Published by American Medical Association (AMA) in JAMA
- Vol. 279 (24) , 1968-1972
- https://doi.org/10.1001/jama.279.24.1968
Abstract
CESAREAN DELIVERY is currently the most commonly performed major surgical procedure in the United States. Between 1972 and 1992, the proportion of infants delivered via cesarean increased roughly 4-fold, making rates in the United States among the highest in the industrialized world.1,2 These data have raised questions regarding the appropriateness of current practices.3,4 Moreover, the higher costs associated with cesarean delivery have led to efforts by insurers, managed care organizations, and others to decrease rates.5,6 As a result, hospitals and health plans are often ranked on the basis of cesarean delivery rates, with the implicit assumption that lower rates reflect more appropriate, as well as more efficient, clinical practice. For example, the Public Citizen's Health Research Group recently reported cesarean delivery rates for 3159 hospitals in 41 states and the New England HEDIS Coalition reported rates for 15 health plans in 1993.7,8Keywords
This publication has 1 reference indexed in Scilit:
- Cost-Effectiveness and Obstetric ServicesMedical Care, 1991