The association between hospital obstetrical volume and maternal postpartum complications

Kathy L. Kyser; Xin Lu; Donna A. Santillan; Mark K. Santillan; Stephen K. Hunter; Alison G. Cahill; Peter Cram

doi:10.1016/j.ajog.2012.05.010

The association between hospital obstetrical volume and maternal postpartum complications

Kathy L. Kyser, Xin Lu, Donna A. Santillan, Mark K. Santillan, Stephen K. Hunter, Alison G. Cahill, Peter Cram

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: The purpose of this study was to examine the relationship between delivery volume and maternal complications. STUDY DESIGN: We used administrative data to identify women who had been admitted for childbirth in 2006. Hospitals were stratified into deciles that were based on delivery volume. We compared composite complication rates across deciles. RESULTS: We evaluated 1,683,754 childbirths in 1045 hospitals. Decile 1 and 2 hospitals had significantly higher rates of composite complications than decile 10 (11.8% and 10.1% vs 8.5%, respectively; P < .0001). Decile 9 and 10 hospitals had modestly higher composite complications as compared with decile 6 (8.8% and 8.5% vs 7.6%, respectively; P < .0001). Sixty percent of decile 1 and 2 hospitals were located within 25 miles of the nearest greater volume hospital. CONCLUSION: Women who deliver at very low-volume hospitals have higher complication rates, as do women who deliver at exceedingly high-volume hospitals. Most women who deliver in extremely low-volume hospitals have a higher volume hospital located within 25 miles.

Original language	English (US)
Pages (from-to)	42.e1-42.e17
Journal	American journal of obstetrics and gynecology
Volume	207
Issue number	1
DOIs	https://doi.org/10.1016/j.ajog.2012.05.010
State	Published - Jul 2012
Externally published	Yes

Keywords

complication
obstetrical volume
patient safety

ASJC Scopus subject areas

Obstetrics and Gynecology

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10.1016/j.ajog.2012.05.010

Cite this

@article{4b49a34ae5aa46e39e1a52816dce7741,

title = "The association between hospital obstetrical volume and maternal postpartum complications",

abstract = "OBJECTIVE: The purpose of this study was to examine the relationship between delivery volume and maternal complications. STUDY DESIGN: We used administrative data to identify women who had been admitted for childbirth in 2006. Hospitals were stratified into deciles that were based on delivery volume. We compared composite complication rates across deciles. RESULTS: We evaluated 1,683,754 childbirths in 1045 hospitals. Decile 1 and 2 hospitals had significantly higher rates of composite complications than decile 10 (11.8% and 10.1% vs 8.5%, respectively; P < .0001). Decile 9 and 10 hospitals had modestly higher composite complications as compared with decile 6 (8.8% and 8.5% vs 7.6%, respectively; P < .0001). Sixty percent of decile 1 and 2 hospitals were located within 25 miles of the nearest greater volume hospital. CONCLUSION: Women who deliver at very low-volume hospitals have higher complication rates, as do women who deliver at exceedingly high-volume hospitals. Most women who deliver in extremely low-volume hospitals have a higher volume hospital located within 25 miles.",

keywords = "complication, obstetrical volume, patient safety",

author = "Kyser, {Kathy L.} and Xin Lu and Santillan, {Donna A.} and Santillan, {Mark K.} and Hunter, {Stephen K.} and Cahill, {Alison G.} and Peter Cram",

note = "Funding Information: Supported in part by the Robert Wood Johnson Physician Faculty Scholars Program (A.G.C.); by NIH grant number R01GM090148 (D.A.S. and S.K.H.); by the University of Iowa Institute for Clinical and Translational Science KL2 Scholar program ( NIH grant number KL2RR024980-2 ) and by the Reproductive Scientist Development Program ( NIH grant number K12 HD000849 ; M.K.S.); by a K23 career development award ( RR01997201 ) from the National Center for Research Resources , NIH (grant number R01 HL085347-01A1 , NHLBI , NIH ), the Robert Wood Johnson Physician Faculty Scholars Program; and the Department of Veterans Affairs (P.C.). ",

year = "2012",

month = jul,

doi = "10.1016/j.ajog.2012.05.010",

language = "English (US)",

volume = "207",

pages = "42.e1--42.e17",

journal = "American journal of obstetrics and gynecology",

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T1 - The association between hospital obstetrical volume and maternal postpartum complications

AU - Kyser, Kathy L.

AU - Lu, Xin

AU - Santillan, Donna A.

AU - Santillan, Mark K.

AU - Hunter, Stephen K.

AU - Cahill, Alison G.

AU - Cram, Peter

N1 - Funding Information: Supported in part by the Robert Wood Johnson Physician Faculty Scholars Program (A.G.C.); by NIH grant number R01GM090148 (D.A.S. and S.K.H.); by the University of Iowa Institute for Clinical and Translational Science KL2 Scholar program ( NIH grant number KL2RR024980-2 ) and by the Reproductive Scientist Development Program ( NIH grant number K12 HD000849 ; M.K.S.); by a K23 career development award ( RR01997201 ) from the National Center for Research Resources , NIH (grant number R01 HL085347-01A1 , NHLBI , NIH ), the Robert Wood Johnson Physician Faculty Scholars Program; and the Department of Veterans Affairs (P.C.).

PY - 2012/7

Y1 - 2012/7

N2 - OBJECTIVE: The purpose of this study was to examine the relationship between delivery volume and maternal complications. STUDY DESIGN: We used administrative data to identify women who had been admitted for childbirth in 2006. Hospitals were stratified into deciles that were based on delivery volume. We compared composite complication rates across deciles. RESULTS: We evaluated 1,683,754 childbirths in 1045 hospitals. Decile 1 and 2 hospitals had significantly higher rates of composite complications than decile 10 (11.8% and 10.1% vs 8.5%, respectively; P < .0001). Decile 9 and 10 hospitals had modestly higher composite complications as compared with decile 6 (8.8% and 8.5% vs 7.6%, respectively; P < .0001). Sixty percent of decile 1 and 2 hospitals were located within 25 miles of the nearest greater volume hospital. CONCLUSION: Women who deliver at very low-volume hospitals have higher complication rates, as do women who deliver at exceedingly high-volume hospitals. Most women who deliver in extremely low-volume hospitals have a higher volume hospital located within 25 miles.

AB - OBJECTIVE: The purpose of this study was to examine the relationship between delivery volume and maternal complications. STUDY DESIGN: We used administrative data to identify women who had been admitted for childbirth in 2006. Hospitals were stratified into deciles that were based on delivery volume. We compared composite complication rates across deciles. RESULTS: We evaluated 1,683,754 childbirths in 1045 hospitals. Decile 1 and 2 hospitals had significantly higher rates of composite complications than decile 10 (11.8% and 10.1% vs 8.5%, respectively; P < .0001). Decile 9 and 10 hospitals had modestly higher composite complications as compared with decile 6 (8.8% and 8.5% vs 7.6%, respectively; P < .0001). Sixty percent of decile 1 and 2 hospitals were located within 25 miles of the nearest greater volume hospital. CONCLUSION: Women who deliver at very low-volume hospitals have higher complication rates, as do women who deliver at exceedingly high-volume hospitals. Most women who deliver in extremely low-volume hospitals have a higher volume hospital located within 25 miles.

KW - complication

KW - obstetrical volume

KW - patient safety

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JF - American journal of obstetrics and gynecology

IS - 1

ER -

The association between hospital obstetrical volume and maternal postpartum complications

Abstract

Keywords

ASJC Scopus subject areas

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