At more than half (56%) of US hospitals, the rate of cesarean deliveries is above the national target for low-risk births, according to a Consumer Reports analysis of more than 1300 hospitals released today.
The report also finds huge variations in cesarean delivery rates from hospital to hospital, even those within the same ZIP code.
Cesarean delivery is now the most common surgery performed in US hospitals; about 1 in 3 (about 1.3 million) babies are born every year by cesarean delivery, the report notes.
Cesarean delivery rates are higher in the Northeast and South and lower in the West and Midwest, according to the report. In four states, the rate of cesarean delivery was 30% or higher: West Virginia (31%), Florida (31%), Louisiana (32%), and Nebraska (34%, for which only one hospital reported data).
In four states, the rate was below 18.5%: South Dakota, Idaho, and New Mexico, all at 17%, and Minnesota, at 18%. The national benchmark set by the US Department of Health and Human Services is 23.9% or less.
There is also wide variation in cesarean deliveries among individual hospitals. For large hospitals, cesarean delivery rates range from 7% at Crouse Hospital in Syracuse, New York, to 51% at South Miami Hospital in Miami, Florida. Of all hospitals rated by Consumer Reports, the rate of cesarean delivery was highest, at 65%, in Hialeah Hospital, located just outside of Miami.
Cesarean delivery rates can vary widely even among hospitals located near one another. Consumer Reports found this pattern in several locations, including St. Louis, Missouri; Cincinnati, Ohio; and Fort Worth, Texas.
"This variation is a critical point in our analysis because there is a big, important take-away for moms. You cannot afford not to know the track record of the hospital where you're delivering," Doris Peter, PhD, director, Consumer Reports Health Ratings Center, said in a statement.
But knowing a hospital's track record may not be easy, because hospitals aren't required to report cesarean delivery data to the public, and not all hospitals do. Consumer Reports did not have data for more than half of the estimated 3000 hospitals in which babies are delivered. There are 28 US hospitals in which more than 5000 births occur each year occur but that do not publicly report their data, they say.
"We applaud those hospitals who do share their cesarean delivery data, particularly the ones who do poorly. We see this as a critical step in the direction toward greater transparency and openness," said Dr Peter.
Overall, there were 216 hospitals with cesarean delivery rates higher than 33.3% for low-risk deliveries in first-time mothers, earning Consumer Reports' worst rating. Of these hospitals, the 22 listed below performed the most deliveries within 1 year.
Table 1. Large Hospitals With High Cesarean Delivery Rates*
|Hospital||Cesarean Rate (%)|
|South Miami Hospital, Miami, Fla||51|
|Richmond University Medical Center, Staten Island, NY||44|
|Hackensack University Medical Center, Hackensack, NJ||43|
|Woman's Hospital of Texas, Houston, Texas||41|
|Midland Memorial Hospital, Midland, Texas||40|
|Inova Fairfax Hospital, Falls Church, Va||39|
|Las Palmas Medical Center, El Paso, Texas||39|
|Texas Health Presbyterian Hospital, Plano, Texas||39|
|Memorial Regional Hospital, Hollywood, Fla||38|
|Henrico Doctors' Hospital, Richmond, Va||37|
|Doctor's Hospital at Renaissance, Edinburg, Texas||37|
|Baptist Hospital of Miami, Miami, Fla||37|
|Riverside Community Hospital, Riverside, Calif||36|
|Bayshore Medical Center, Pasadena, Texas||35|
|Jackson Health System, Miami, Fla||35|
|Boca Raton Regional Hospital, Boca Raton, Fla||34|
|St. Joseph's Healthcare System, Paterson, NJ||34|
|Medical Center at Bowling Green, Ky||34|
|Baylor All Saints Med Center at Fort Worth, Texas||34|
|Wesley Medical Center, Wichita, Kan||34|
|Inova Alexandria Hospital, Alexandria, Va||34|
|Baptist Medical Center, San Antonio, Texas||34|
*Rates are for hospitals with either at least 3500 total deliveries in 2015 or 750 low-risk births in either 2015 or the 9-month period ending in Sept 2015 or June 2016.
Conversely, there were 203 hospitals in which the rate was 18.4% or lower, earning Consumer Reports' best rating. Twenty-two of them were hospitals in which a high volume of babies were delivered.
Table 2. Large Hospitals With Low Cesarean Delivery Rates*
|Hospital||Cesarean Rate (%)|
|Crouse Hospital, Syracuse, NY||7|
|SSM St. Mary's Health Center, St. Louis, Mo||12|
|Memorial Medical Center, Springfield, Ill||12|
|Lovelace Women's Hospital, Albuquerque, NM||13|
|Bakersfield Memorial Hospital, Bakersfield, Calif||13|
|Utah Valley Regional Medical Center, Provo, Utah||14|
|WakeMed Raleigh Campus, Raleigh, NC||15|
|Intermountain Medical Center, Murray, Utah||16|
|Desert Regional Medical Center, Palm Springs, Calif||16|
|NorthShore University Health System, Evanston, Ill||17|
|Kaiser Permanente Panorama City Med Center, Calif||17|
|Kaleida Health, Buffalo, NY||17|
|Northwestern Memorial Hospital, Chicago, Ill||17|
|TMC HealthCare, Tucson, Ariz||17|
|University Medical Center, Lubbock, Texas||17|
|Providence Regional Med Center Everett, Wash||17|
|San Joaquin Community Hospital, Bakersfield, Calif||18|
|Christiana Care Health System, Newark, Del||18|
|Bethesda North Hospital, Cincinnati, Ohio||18|
|Kaiser Permanente Roseville Med Center, Calif||18|
|JPS Health Network, Fort Worth, Texas||18|
|Southwest Healthcare System, Murrieta, Calif||18|
*Rates are for hospitals in which at least 3500 total deliveries occurred in 2015 or 750 low-risk births occurred in either 2015 or the 9-month period ending in Sept 2015 or June 2016.
Consumer Reports. Published online May 16, 2017. Full text
Medscape Medical News © 2017
Cite this: Cesarean Rates Above Target at More Than Half of US Hospitals - Medscape - May 16, 2017.