Nearly half of the hospitals queried about caesarean section rates by researchers from the Leapfrog Group declined to provide the information.
Why can't we get cesarean sections right? We've had the feminist women's health movement followed by evidence-based medicine and now the push for patient engagement. Still, more than half of all hospitals are doing too many C-sections, according to this week's report from the Leapfrog Group, a national advocate for patient safety.
Known for its consumer-friendly "Hospital Safety Scores," Leapfrog has taken on cesarean sections. "Never before have purchasers or patients had a single, standardized C-section rate to compare by hospital at the national level," the group notes.
It's technically true, but Consumer Reports also scores hospitals on C-section rates. CR's findings only include hospitals in the 22 state where public data is available, however.
The Leapfrog Group tried to take if further by adding a C-section query to its annual survey of 2,500 hospitals. But, click on the "Find your Hospital's Rate" link and you get a long list of institutions that "declined to respond."
Granted, the list is alphabetical and Alabama hospitals seem especially reluctant to report. Only six of roughly 90 hospitals in the state voluntarily shared their C-section data with Leapfrog. And while some of the 2,500 hospitals surveyed don't offer obstetrics, the net result is that only 1,122 hospitals disclosed their rates.
Consumer Reports offers more information on questionable pregnancy and birth procedures, with this document: The Risks of C-sections: What Hospitals Don't Want You to Know.
Is there also something about the C-section rates that they don't want us to know? Let's not assume any variation of this scenario, such as that hospitals are looking the other way because doctors make these choices. And those doctors must know what they are doing and, by the way, they are keeping beds filled and revenue up. Also, Medicare isn't watching because not many women over 65 are having babies. (With assisted reproductive technology, that's not unheard of.)
Let's speculate that some hospitals are watching their numbers internally and acting on them, even if they don't want to share them. Or that they might not be tracking C-section data at all.
Still, in talking to a reporter from New Jersey, Leapfrog CEO Leah Binder said she was concerned about the ten Garden State hospitals that declined to respond to the Leapfrog survey. "You do have to worry as to why they're not reporting," she said in the article.
Tinker Ready is a contributing writer at HealthLeaders Media.