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Abstract
Purpose: To determine the association between obstetric outcomes and publicly reported hospital data on patient satisfaction, surgical quality measures and medical outcomes.
Materials and methods: Hospitals in the Nationwide Inpatient Sample in 2011 were linked to Hospital Compare, a source of hospital data on patient satisfaction, quality and mortality for medical conditions. The risk-adjusted hospital-level rates of obstetric morbidity, episiotomy and lacerations were compared across the hospitals and reported as the absolute reduction in risk (ARR).
Results: We identified 528 708 women. There was no association between any of the metrics and risk-adjusted obstetric morbidity (range −0.15% to 0.03% difference). Hospitals with a high mortality rate for pneumonia had a 0.38% (95% CI: 0.13% to 0.64%) higher rate of risk-adjusted third- and fourth-degree lacerations, while hospitals with a higher death rate for myocardial infarction had a −0.74% (95% CI, −1.34% to −0.14%) lower risk-adjusted episiotomy rate. The differences in the remainder of the publicly reported metrics and the risk adjusted rates of third- and fourth-degree lacerations and episiotomy were small and not statistically significant (p > 0.05).
Conclusion: There is little association between currently available, publically reported hospital data and obstetric quality. Obstetric-specific hospital measures of quality and satisfaction are needed.
Declaration of interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article. Dr. Wright (R40 MC28312-01) is a recipient of a grant from the Department of Health and Human Services, 10.13039/100000016.
Supplementary materials available on line
