Colorado is the only state in a recent report by HealthGrades to rank in the top ten for all three aspects of women’s care studied (see appendix D on page 15 of the report). Although only three hospitals in Colorado received the HealthGrades 2009/2010 Women’s Health Excellence Award: North Colorado Medical Center in Greeley, Poudre Valley Hospital in Fort Collins, and Centura Health-Penrose Saint Francis Health Services in Colorado Springs.
The HealthGrades study also studied maternity care at hospitals in 19 states (Colorado was not one of them), and found very significant differences in outcomes between the best hospitals and the worst. The best-performing hospitals had 56% lower neonatal mortality than the worst-performing hospitals, and 52% fewer maternal complications for vaginal births. They also had 76% fewer complications among women who had c-sections. If all hospitals in the study had performed on the level of the best-performing hospitals in the study, it’s estimated that 182,129 women could have avoided one or more maternity-related complications between 2005 and 2007.
One thing to keep in mind is that there are other factors at play besides the hospital’s performance when it comes to complications of pregnancy and childbirth. If a patient is non-compliant with pre-natal care recommendations, her outcome may be worse than a compliant woman’s, despite both receiving the same care at the time of delivery. In addition, factors like obesity, diabetes, cardiovascular illness, tobacco use, etc. can all contribute to complications after a birth, even in hospitals that provide excellent care. So I wonder if perhaps the worst-performing hospitals might have been located in poorer neighborhood where the women were more likely to be overweight, smokers, or without access to health insurance, routine health care and/or prenatal care? It appears that the HealthGrades study did use a risk-adjustment methodology in ranking hospitals in terms of overall women’s health. But in the maternity care report, it looks like the results were based on complication numbers alone (separated out by vaginal, c-section, and voluntary c-section).
