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Improvements in US Maternal Obstetrical Outcomes from 1992 to 2006. 1.14.09

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Leonard Davis Institute of Health Economics
Leonard Davis Institute of Health Economics

Author: Sindhu Srinivas

Health & Medicine
1 of 1
[object Object],[object Object],CONCLUSIONS ABSTRACT Sindhu K. Srinivas, MD 1 , Andrea G. Edlow, MD 1 , Jamie Bastek, MD1, Christina M. Andrela, BSN 1 , Michal A. Elovitz, MD 1 Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Center for Research on Reproduction and Women’s Health, University of Pennsylvania, Philadelphia, PA 1 Objective : Changing quality of care should be reflected in changing outcomes over time. We examined 15-year trends in risk-adjusted maternal complications following childbirth. Methods: Using Florida and New York hospital discharge data from 1992-2006, we examined maternal obstetrical outcomes among over 6 million women undergoing cesarean delivery (CD) and vaginal delivery (VD). Obstetric procedures and individual and composite maternal post delivery complications including infection, hemorrhage, laceration, and other major operative and thrombotic complications were evaluated. Results: During the 15-year time period, the CD rate decreased from 24.7% in 1992 to 23% in 1996 and increased to 34.7% in 2006. The risk-adjusted rate of any major complication declined from 14.7% in 1992 to 10.7% in 2006 for all deliveries; from 14.4% to 11.6% for VD; and from 15.7% to 8.5% for CD. During 1992 to 2006, the average number of comorbidities increased from 0.65 to 0.93 for patients overall, from 0.43 to 0.58 for VD patients, and 1.34 to 1.59 for CD patients. Conclusion: As evidenced by New York and Florida, the US has seen large reductions in major maternal complications over the past 15 years. Concurrently, the average number of comorbidities increased. These results may reflect improvements in US maternal care over the study period. ,[object Object],OBJECTIVE RESULTS METHODS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Improvements in US maternal obstetrical outcomes from 1992 to 2006 Sindhu K. Srinivas, MD, MSCE 1,2 , Andrew J. Epstein, PhD 3 , Sean Nicholson, PhD 4 , Jeph Herrin, PhD 3 , David A. Asch, MD, MBA 2,5 1 Department of OB/GYN, CRRWH, University of Pennsylvania, 2 Leonard Davis Institute of Health Economics, University of Pennsylvania, 3 Yale University, 4 Cornell University, 5 Center for Health Equity Research and Promotion, Philadelphia VA Medical Center BACKGROUND ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Improvements in US Maternal Obstetrical Outcomes from 1992 to 2006. 1.14.09

  • 1.