National Partnership for Women & Families

Daily Women's Health Policy Report

June 26, 2008

Birth complications and how they are handled generate the greatest quality gaps in maternal care between best- and worst-performing hospitals nationwide, according to an annual study released Tuesday by HealthGrades, CQ HealthBeat reports. According to the study, there are about 76% fewer complications during caesarean section deliveries at the best-performing hospitals than there are at the worst. In addition, there are about 51% fewer complications at best-performing hospitals for vaginal births (Parnass, CQ HealthBeat, 6/24).

For the study, HealthGrades analyzed 12.5 million hospital delivery and newborn records from 2004 to 2006 in 17 states. Researchers assessed maternity care program performance by studying maternal complication rates and neonatal mortality. Best-performing hospitals were those that had the lowest combined rates of maternal complications and weight-stratified neonatal mortality (HealthGrades release, 6/24).

Scott Shapiro, senior vice president of corporate communications and marketing for HealthGrades, said that the findings reflect a "quality chasm" among hospitals but that there is evidence of an increasing broad range of initiatives among hospitals to address mortality rates and close the gap. Samantha Collier -- HealthGrades chief medical officer and lead author of the study -- said, "It is imperative, based on the huge differences in the quality identified in our study, that women research their local hospital's clinical outcomes before choosing where to receive their care."

The study also examined hospitals' treatment of heart disease and stroke in women, including those who were pregnant. Researchers found that mortality rates were 40% lower in top-performing hospitals and 22% lower in average-performing hospitals. The study found that overall mortality rates for women with cardiovascular disease improved by almost 15% from 2004 to 2006. Last year's study found an 8.7% improvement in the rate from 2003 to 2005.

"The good news in today's report is the sharp drop in mortality for cardiovascular disease for women from 2004 to 2006," Alicia Mitchell, vice president of media relations for the American Hospital Association, said, adding, "One study can never fully capture every aspect of what goes into quality treatment. We urge the public to use all available data -- combined with conversations with their physician, family members and friends -- to build a more complete picture of quality of care" (CQ HealthBeat, 6/24).