Health Care

Health safety group: South Florida hospitals perform too many C-sections

The average rate of cesarean section surgeries for Florida hospitals was among the highest in the nation — about 32 for every 100 deliveries — according to a study released Wednesday by The Leapfrog Group, a nonprofit that surveys hospitals for quality and safety measures.

The numbers, which were self-reported by Florida hospitals and included only first-time, low-risk mothers with single babies, exceeded the recommended target of about 24 for every 100 deliveries.

Hospitals in Miami, Hialeah, Fort Lauderdale and Hollywood reported an even higher rate, about 45 for every 100 deliveries. There were wide variations, with some hospitals reporting C-sections in more than half of all deliveries. Some hospitals declined to report any data.

Nationally, most hospitals self-reporting C-section deliveries also exceeded the recommended rate, reflecting concerns from the American College of Obstetricians and Gynecologists over the rapid increase in such deliveries from 1996 to 2011 without clear evidence that they lead to better outcomes.

Leapfrog’s data were designed to help expectant parents choose a hospital for their childbirth, said Leah Binder, chief executive of the group. But, Binder said, she also hopes hospitals will use the data to reduce their rates of C-sections.

“What we see from this data,” she said, “is that not all hospitals are the same, and your likelihood of needing a C-section is actually different depending on which hospital you choose. … Because we see so much variation, we know hospitals need to set their sights on reducing these rates.”

42 Percentage of deliveries by C-section in South Florida as reported by hospitals in 2014.

The C-section rate used by Leapfrog is endorsed by the Joint Commission, a nonprofit that accredits more than 20,000 U.S. hospitals and healthcare programs, and the measure only applies to first-time, low-risk moms with single babies who have reached their 37th week with the baby positioned head-down — indicating a low risk of complication.

Survey results suggest that many hospitals are putting patients at risk by performing medically unnecessary procedures that also are more costly, Binder said.

“C-sections are major abdominal surgery,” she said. “We're not talking about something that’s just a minor fluke. We’re talking about major surgery being performed on women, and probably unnecessarily.”

According to a 2013 study by Truven Health Analytics, a healthcare consultant, average total payments for cesarean section deliveries were about 50 percent higher than average payments with vaginal births for both private insurance — $27,866 vs. $18,329 — and Medicaid, $13,590 vs. $9,131.

Still, the Leapfrog data have limitations. Some South Florida hospitals declined to report any data to the group. And Leapfrog appears to have excluded from the survey some hospitals that could have reported C-section rates.

Hospital C-section rates for 2014

Aventura Hospital and Medical Center, does not apply

Baptist Hospital of Miami, 36.4 percent

Baptist South Miami, 53.4 percent

Baptist West Kendall, 38.8 percent

Hialeah Hospital, 68 percent

Palmetto General, 57 percent

Holtz Children’s, does not apply

Jackson Memorial, 39.8 percent

Jackson North Medical Center, 29.9 percent

Jackson South Community Hospital, 27.9 percent

Kendall Regional, 53.9 percent

Mercy Hospital, 51.8 percent

Miami Children’s, does not apply

North Shore Medical Center, 31.6 percent

Westchester General, does not apply

Holy Cross Hospital, 42.9 percent

Plantation General, 54.7 percent

Broward Health, declined to respond

Cleveland Clinic of Florida, does not apply

Florida Medical Center, does not apply

Memorial Healthcare System, declined to respond

A previous version of this list contained information from Leapfrog Group implying that some hospitals offered obstetrics services in 2014 but hadn’t replied to the survey. The hospitals did not offer obstetrics.

Source: The Leapfrog Group

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