The employer-driven hospital quality watchdog, The Leapfrog Group, announced today that the national rate of early elective deliveries dropped for the second year, according to data submitted to its annual Leapfrog Hospital Survey.
Early elective deliveries—performing elective inductions or cesarean procedures prior to 39 completed weeks gestation without medical necessity—have been decreasing since 2010 when the Leapfrog Group became the first to publicly report hospital rates. This year, 46% of the 773 reporting hospitals met Leapfrog's early elective deliveries target rate of less than 5%, an increase from 39% in 2011. Data from the Leapfrog Hospital Survey is the only national source of this data by hospital.
"Since The Leapfrog Group started drawing attention to the issue, we have seen encouraging improvements in hospital performance," said Leah Binder, president and CEO of The Leapfrog Group. "Our data shows that 75 percent of hospitals improved this year, and the national average dropped from 14.0% to 11.2%, evidence to the commitment many hospitals are making to put babies and mothers first. Still, much more work is needed."
Early elective deliveries can be dangerous, resulting in NICU admissions, increased length of stay, and higher costs to patients and payors. Though Leapfrog remains the only organization reporting rates by hospitals, others are working to educate women, providers, and hospitals about the importance of reducing these high-risk births. Groups including Childbirth Connection, Institute for Healthcare Improvement, March of Dimes, Catalyst for Payment Reform, the Joint Commission, Partnership for Patients, and CMS as part of its Strong Start Initiative, have brought national and regional attention to the pressing healthcare issue.
Despite the nationwide decline in early elective deliveries, widespread variation still exists with some hospitals reporting rates higher than 40%. Noting that several states are now reporting average rates of less than 10%, Binder said the most dramatic improvements are coming from states like South Carolina and Illinois where there has been pressure from local or regional stakeholders to decrease these high risk deliveries. In Illinois, the rate has almost been cut in half (from 13.7% in 2011 to 7.2% in 2012) through efforts by organizations such as the Midwest Business Group on Health.
Added Binder: "It's encouraging to see such swift progress as communities and stakeholders rally together, but our fight is far from finished."
Rates of early elective deliveries by hospital are publicly available on Leapfrog's Compare Hospitals tool.