Measure Status: Active
Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)
Service Type: Bottom level: public health services and systems
Service Recipient: Activities related to systems-building
Goal: Maintain technical assistance to Maryland delivery hospitals (including annual and quarterly data on individual hospital cesarean rates, ACOG guidelines, AIM resources, and policies/strategies) on low-risk cesarean reduction.
Numerator: Number of delivery hospitals that receive technical assistance on low-risk cesarean birth reduction
Denominator: Number of delivery hospitals
Significance: Cesarean delivery can be a life-saving procedure for certain medical indications. However, for most low-risk pregnancies, cesarean delivery poses avoidable maternal risks of morbidity and mortality, including hemorrhage, infection, and blood clots—risks that compound with subsequent cesarean deliveries. Much of the temporal increase in cesarean delivery (over 50% in the past decade), and wide variation across states, hospitals, and practitioners, can be attributed to first-birth cesareans. Moreover, cesarean delivery in low-risk first births may be most amenable to intervention through quality improvement efforts. This low-risk cesarean measure, also known as nulliparous term singleton vertex (NTSV) cesarean, is endorsed by the ACOG, The Joint Commission (PC-02), National Quality Forum (#0471), Center for Medicaid and Medicare Services (CMS) – CHIPRA Child Core Set of Maternity Measures, and the American Medical Association-Physician Consortium for Patient Improvement. MCHB will target hospital-level policy and practice changes to impact the entire population of pregnant women in Maryland. This will be supported by providing technical assistance to delivery hospitals across the state including resources from the Alliance to Improve Maternal Health (AIM), as well as quarterly and annual hospital-level data on cesarean birth rates.
Data Sources and Data Issues: MCHB and Maryland Patient Safety Center Data
Unit Type: Count, Unit Number: 32