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Watchdog: Rate of early elective deliveries continues to drop

Friday March 7, 2014
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The national rate of maternal early elective deliveries dropped for the third year in a row and hit the target rate of less than 5% for the first time, according to nonprofit hospital quality watchdog The Leapfrog Group.

“This is one of the most extraordinary examples of progress in healthcare that I’ve seen in my career,” Leah Binder, president and CEO of Leapfrog, said in a news release. “It shows that public reporting can galvanize change, and that saves lives.”

Early elective deliveries carry risks to babies and mothers and can result in NICU admissions, increased length of stay and higher costs to patients and payers, according to the news release. The American College of Obstetricians and Gynecologists has advised against these deliveries for more than 30 years.

The results from the 2013 Leapfrog Hospital Survey show a sharp decline in early elective deliveries in the four years since Leapfrog became the first to publicly report on this vital maternity care measure. The national average of 4.6% in 2013 is down from a 17% rate in 2010.

The rate of early elective deliveries was cut in half from 2012, when it was 11.2%. In 2013, 71% of the reporting hospitals met Leapfrog’s early elective deliveries target rate of less than 5%, compared with 46% of hospitals in the 2012 survey. Leapfrog also reports a spike in its survey participation, with 969 hospitals reporting on early elective deliveries in 2013, up 200 hospitals from last year. Leapfrog was the first to publicly report rates of early elective deliveries by hospital.

The 2013 data reveals that the vast majority of states are reporting early elective delivery average rates of less than 10%, with standouts such as California, Colorado, Maine and Massachusetts boasting rates at 3% or lower. Binder noted dramatic improvements from states such as South Carolina, where payment reform penalties enacted by government and private sector stakeholders effectively are discouraging the practice of early elective deliveries.

Despite nationwide and statewide successes, widespread variation still exists, Binder noted. “Some hospitals are still reporting early elective delivery rates higher than 20% and 30%, which means there is still work to be done.

A leader in maternity care data, Leapfrog this year begins collecting data on cesarean section rates for hospitals reporting at least 50 births annually. Hospital rates of nulliparous term singleton vertex cesarean section delivery will be publicly reported on the Leapfrog Hospital Survey Results website (www.leapfroggroup.org/cp) in 2015.

“Just as we’ve seen early elective delivery rates drop after Leapfrog began publicly reporting them, we hope to spur national efforts to bring down the rate of C-sections,” Binder said.

Rates of early elective deliveries by hospital and statewide averages: www.LeapfrogGroup.org/TooEarlyDeliveries


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