Wide Variation in Cesarean Rates Across U.S. Hospitals

Even wider variation seen among women with lower-risk pregnancies
Wide Variation in Cesarean Rates Across U.S. Hospitals

WEDNESDAY, March 13 (HealthDay News) -- Rates of cesarean delivery vary about 10-fold across a sample of U.S. hospitals nationwide, according to a study published in the March issue of Health Affairs.

Katy Backes Kozhimannil, Ph.D., from the University of Minnesota School of Public Health in Minneapolis, and colleagues examined rates of cesarean delivery using data from the 2009 National Inpatients Sample from 593 U.S. hospitals nationwide.

The researchers found that the mean hospital-level rate of cesarean delivery was 32.8 percent, with considerable variation noted across hospitals, from 7.1 to 69.9 percent. For women with lower-risk pregnancies, which were expected to show less variation, the rate of cesarean deliveries varied more widely, from 2.4 to 36.5 percent. The mean hospital-level cesarean delivery rate was comparable across all hospital categories, and across bed size, location, and teaching categories.

"The variations in hospital cesarean rates that we uncovered were striking in their magnitude and remain large even after stratification by hospital size, teaching status, and geographic location," write the authors. "These variations have important health and cost implications for state and federal public health agencies, the Centers for Medicare and Medicaid Services, state Medicaid programs, Medicaid managed care plans, hospitals, health care providers, and the four million American families that brought a newborn home from the hospital in 2009."

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