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More than half of hospitals exceed cesarean delivery benchmark


 

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More than 60% of hospitals have cesarean delivery rates that are higher than national benchmarks, according to a new report from the Leapfrog Group.

The Leapfrog Group, a national quality organization, surveyed 1,122 hospitals around the country to determine how many institutions were hitting the target rate of no more than 23.9% C-sections per year. The fact that less than half of U.S. hospitals are meeting the benchmark rate is troubling, said Leapfrog Group president and CEO, Leah Binder.

“This means that far too many women are undergoing a major abdominal surgery without medical necessity – with all the risks that any surgery entails,” Ms. Binder said in a statement, adding that the number of hospitals that did not report their cesarean rates is another cause for concern among patients and providers.

Dr. Elliott K. Main

Dr. Elliott K. Main

Rural hospitals performed best in the survey, with nearly half of hospitals performing cesareans at the target rate or less frequently. Utah and Idaho, in particular, had statewide cesarean rates lower than 20%. However, only about 37% of urban hospitals met the benchmark rate.

The Leapfrog survey used the Nulliparous Term Singleton Vertex Cesarean Section Rate measure, which identifies pregnancies that are unlikely to need surgical intervention during labor. The measure has been endorsed by the Joint Commission, the National Quality Forum, and the Centers for Medicare & Medicaid Services. The Leapfrog Group’s target cesarean rate of 23.9% comes from the Healthy People 2020 initiative.

“This is really about how well we – as doctors, nurses, midwives, and hospitals – support labor,” Dr. Elliott Main, chair of Leapfrog’s Maternity Care Expert Panel, said in a statement. “Hospital staff that support labor appropriately and are sensitive to families’ birth plans are shown to have lower C-section rates overall. If we want to improve this rate across the board, then hospitals must hold themselves to this standard to ensure safe short- and long-term outcomes for both mom and baby.”

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