Hospital Report Cards TM Maternity Care and Women's Health Methodology 2007-2008 2
© Copyright 2007 Health Grades, Inc. All rights reserved.
May not be reprinted or reproduced without permission from Health Grades, Inc.
Methodology for Maternity Care
HealthGrades analyzed the following four factors for each hospital:
·
Volume of vaginal and cesarean section (C-section) single live-born deliveries
·
Maternal complication rate single live-born deliveries for women undergoing vaginal delivery and
C-section delivery for clinical reasons (See Exhibit B for a list of complications)
·
Maternal complication rate among women undergoing "patient-choice" or non-clinically indicated C-
sections
·
Newborn mortality rate stratified into nine weight categories
For each of the above factors except volume, hospitals were ranked separately based on whether or not
they have a newborn ICU. The presence of a newborn ICU was defined as being an intermediate or
intensive care unit for newborn care. Typically, intermediate care or intensive care newborn units allow for
the care of premature infants, infants requiring mechanical ventilation or neonatal surgery, infants with
congenital heart disease or malformations requiring immediate evaluations and monitoring, and/or infants
with low birth weight.
Volume of Vaginal and C-section Deliveries
Vaginal and C-section delivery volumes were analyzed. To preserve the integrity of the data, HealthGrades
conducted a series of quality checks. Based on the results of these checks, HealthGrades excluded a
limited number of cases because they were inappropriate for inclusion. Examples of excluded patient
records for delivery volume were:
·
Patients over the age of 55
·
Patients whose sex were listed as male or unknown (except for California*)
·
Patients who left against medical advice, were still in the hospital, were transferred to another
acute care facility, or whose discharge status was unknown (except for California*)
*California data were treated differently due to intentional data masking done by the state.
Only single, live-born deliveries were counted. A list of the codes used by HealthGrades to identify patients
can be found in Exhibit A.
To derive a score for volume, HealthGrades ordered patient counts for combined vaginal and C-section
single deliveries and calculated percentiles in descending order. The highest volume hospital received a
percentile score of 0, and the lowest volume received a score of 100.
Maternal Complication Rate Vaginal and C-section Single Live-born
Deliveries
The same group of patients for the volume measurement was included for analysis in this complication
measurement. Only major complications were considered. A list of the complication codes analyzed can be
found in Exhibit B.
To derive a score for this complication rate, HealthGrades calculated complication rates for vaginal and C-
section births separately within each hospital group (NICU and non-NICU hospitals). Percentiles were then
calculated for each measure (vaginal or C-section delivery) within each hospital group. To derive the final
