Of the 757 hospitals that volunteer to report data on obstetric care quality, too many have obstetricians who still schedule dangerous elective Cesareans and inductions too early rather than encouraging spontaneous deliveries, according to the Leapfrog Group's second survey of the practice, the only one of its kind.
The rate, however, has improved a little in the last year. Of those voluntarily reporting hospitals, 39% reported a rate of 5% or fewer elective newborn deliveries, compared with 30% from the previous year, said Leapfrog CEO Leah Binder. Of all the hospitals reporting, she said, 65% improved their performance over 2010, "the first indication that hospitals are making an effort to eliminate this risky practice."
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Early elective deliveries are still unacceptably high, the report suggests, with rates widely variable throughout the country. Binder estimates that $1 billion could be saved annually in the U.S. in healthcare dollars "if the rate of early (unnecessary) elective deliveries could be reduced to 1.7%, which many of our hospitals have shown they can achieve."
About 32 hospitals are at the opposite end of the spectrum, however, with rates of early elective interventions greater than 40%, according to Leapfrog's latest survey. About 140 hospitals had rates of 20% or higher. Leapfrog's survey shows rates by state as well, with Alabama hospitals showing an average of 22.5%.
The 10-year old watchdog group, which collects hospital cost and quality data for employers, health plans, and other purchasers of healthcare services, is an advocate of transparency for hospital quality process and outcome measures.