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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 25 Research Studies DisplayedPineles BL, Harris AD, Goodman KE
Adverse maternal and delivery outcomes in children and very young (age ≤13 years) US adolescents compared with older adolescents and adults.
This study compared adverse maternal and delivery outcomes of pregnant 10- to 13-year-olds vs 14- to 17-year-olds and 18- to 19-year-olds. This cross-sectional study looked at all patients aged 10 to 19 years who delivered at hospitals in the Premier Healthcare Database from January 2019 through May 2021. The study included 90,876 deliveries across 655 US hospitals. Controlling for patient race and ethnicity, insurance type, and obesity status: 10- to 13-year-olds had significantly higher risks of preterm delivery and cesarean delivery compared with 14- to 17-year-olds. The risk of preeclampsia was not higher for 10- to 13-year-olds compared to 14- to 17-year-olds. There was a higher risk of preterm delivery for 10- to 13-year-olds compared to 18- to 19-year-olds, but not significantly different for cesarean delivery and preeclampsia.
AHRQ-funded; HS028363.
Citation: Pineles BL, Harris AD, Goodman KE .
Adverse maternal and delivery outcomes in children and very young (age ≤13 years) US adolescents compared with older adolescents and adults.
JAMA 2022 Nov 1;328(17):1766-68. doi: 10.1001/jama.2022.18340..
Keywords: Children/Adolescents, Pregnancy, Labor and Delivery, Women, Outcomes, Adverse Events, Maternal Care
Hirai AH, Owens PL, Reid LD
AHRQ Author: Owens PL, Reid LD
Associations between state-level severe maternal morbidity and other perinatal indicators.
This study used the HCUP State Inpatient Databases (HCUP-SID) to determine the correlation between state-level severe maternal morbidity (SMM) rates and perinatal indicators. HCUP-SID was analyzed from 2017 to 2019 using revised code sets for 20 indicators excluding blood transfusions. Perinatal indicators used included prepregnancy hypertension, prepregnancy diabetes, prepregnancy obesity, low-risk cesarean delivery, preterm birth, infant mortality, and maternal mortality. HCUP-SID data for 10,542,942 maternal deliveries and 11,394,752 live births from the National Vital Statistics System (NVSS) were aggregated for state-level analysis. SMM rates were significantly correlated with 2 of the 7 perinatal indicators: prepregnancy hypertension and low-risk cesarean deliveries. All other perinatal indicators were significantly associated with at least 4 of 7 other indicators, and most correlations were higher in magnitude. Maternity mortality rates were highest in the southeast.
AHRQ-authored.
Citation: Hirai AH, Owens PL, Reid LD .
Associations between state-level severe maternal morbidity and other perinatal indicators.
JAMA Netw Open 2022 Jul;5(7):e2224621. doi: 10.1001/jamanetworkopen.2022.24621..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Women, Labor and Delivery, Hospitalization
Smith AJB, Zhou RA, Sites E
Childbirths at home and in birthing centers rose during COVID-19: Oregon 2020 vs prior years.
This study’s objectives were to compare place of birth between 2020 and years before the COVID-19 pandemic and to investigate whether changes in place of birth differed between system-owned and independent hospitals and urban and rural regions in Oregon. Findings showed that, in Oregon, in-hospital births declined significantly during the first year of COVID-19 and affected system-owned hospitals more than independent ones. Further, shifts toward out-of-hospital births occurred in both urban and rural areas.
AHRQ-funded; HS024072.
Citation: Smith AJB, Zhou RA, Sites E .
Childbirths at home and in birthing centers rose during COVID-19: Oregon 2020 vs prior years.
Am J Obstet Gynecol 2022 Jul;227(1):108-11. doi: 10.1016/j.ajog.2022.03.027..
Keywords: Labor and Delivery, Pregnancy, Women, COVID-19
Hirai AH, Owens PL, Reid LD
AHRQ Author: Owens PL, Reid LD
Trends in severe maternal morbidity in the US across the transition to ICD-10-CM/PCS from 2012-2019.
This study evaluated national and state trends in severe maternal morbidity (SMM) rates from 2012 to 2019, and potential disruptions associated with the transition to International Classification of Diseases, 10th Revision, Clinical Modification and Procedure Coding System (ICD-10-CM/PCS) in October 2015. This repeated cross-sectional analysis examined delivery hospitalizations in the HCUP’s National Inpatient Sample and State Inpatient Databases. There were almost 6 million delivery hospitalizations in the national sample representing a weighted total of 29.8 million deliveries with a mean maternal age of 28.6 years. SMM rates increased from 69.5 per 10,000 deliveries to 79.7 per 10,000 in 2019 without a significant change across the ICD-10-CM/PCS transition. OF 20 SMM indicators, rates for 10 indicators increased while 3 significantly decreased with 5 of those changes associated with the ICD-10-CM/PCS transition. Acute kidney failure had the largest increase, from 6.4 to 15.3 per 10,000 delivery hospitalizations, with no change associated with ICD transition. Disseminated intravascular coagulation had the largest decrease from 31.3 to 21.2 per 10,000, with a significant drop associated with ICD transition. State SMM rates significantly decreased for 1 state and significantly increased for 21 states from 2012 to 2019 and with varying associations with ICD transition.
AHRQ-authored.
Citation: Hirai AH, Owens PL, Reid LD .
Trends in severe maternal morbidity in the US across the transition to ICD-10-CM/PCS from 2012-2019.
JAMA Netw Open 2022 Jul;5(7):e2222966. doi: 10.1001/jamanetworkopen.2022.22966..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Women, Labor and Delivery, Hospitalization
Dude AM, Schueler K, Schumm LP
Preconception care and severe maternal morbidity in the United States.
This study’s objective was to measure the association between preconception care and the odds of severe maternal morbidity among women with Medicaid using a secondary analysis of Medicaid claims using Medicaid Analytic Extract files. Findings showed that contraceptive services in the year before conception and routine exams for women with chronic disease were associated with decreased odds of severe maternal morbidity or death for Medicaid enrollees.
AHRQ-funded; HS027027.
Citation: Dude AM, Schueler K, Schumm LP .
Preconception care and severe maternal morbidity in the United States.
Am J Obstet Gynecol MFM 2022 Mar;4(2):100549. doi: 10.1016/j.ajogmf.2021.100549..
Keywords: Maternal Care, Pregnancy, Women, Labor and Delivery, Sexual Health
Flannery DD, Mukhopadhyay S, Morales KH
Delivery characteristics and the risk of early-onset neonatal sepsis.
This retrospective cohort study identified term and preterm infants at lowest risk of culture-confirmed early-onset sepsis (EOS) using delivery characteristics and also determined antibiotic use among them. The study cohort included term and preterm infants born 2009 to 2014 with blood culture with or without cerebrospinal fluid culture obtained ≤72 hours after birth. Low EOS risk criteria included: cesarean delivery, without labor or membrane rupture before delivery, and no antepartum concern for intraamniotic infection or nonreassuring fetal status. Among 53,575 births, 7549 (14.1%) were evaluated and 41 (0.5%) of those infants had EOS. For 1121 evaluated infants there were low-risk delivery characteristics and none had EOS. Duration of antibiotics administered to infants born with and without low-risk characteristics was not different.
AHRQ-funded; HS027468.
Citation: Flannery DD, Mukhopadhyay S, Morales KH .
Delivery characteristics and the risk of early-onset neonatal sepsis.
Pediatrics 2022 Feb;149(2). doi: 10.1542/peds.2021-052900..
Keywords: Newborns/Infants, Sepsis, Risk, Labor and Delivery, Antibiotics, Medication
Cliff BQ
Do high-deductible health plans affect price paid for childbirth?
The purpose of this study was to test whether out-of-pocket costs and negotiated hospital prices for childbirth change after enrollment in high-deductible health plans (HDHPs) and whether price effects differ in markets with more hospitals. Administrative medical claims data from three large commercial insurers with plans in all U.S. states was provided by the Health Care Cost Institute. Findings showed that prices for childbirth in markets with more hospitals decreased after HDHP switch due to lower hospital prices for HDHPs relative to prices at those same hospitals for non-HDHPs.
AHRQ-funded; HS025614.
Citation: Cliff BQ .
Do high-deductible health plans affect price paid for childbirth?
Health Serv Res 2022 Feb;57(1):27-36. doi: 10.1111/1475-6773.13702..
Keywords: Labor and Delivery, Health Insurance, Healthcare Costs, Women
Lyndon A, Simpson KR, Spetz J
Psychometric properties of The Perinatal Missed Care Survey and missed care during labor and birth.
The purpose of this study was to confirm reliability and validity of the Perinatal Missed Care Survey in a large sample of nurses and hospitals, test construct validity with confirmatory factor analysis, and describe the prevalence of missed nursing care during labor and birth. The study found the survey to be a valid and reliable adaptation of the original MISSCARE instrument. This survey could potentially be used to measure nursing care quality and to assess the effectiveness of structural interventions to improve quality and safety.
AHRQ-funded; HS025715.
Citation: Lyndon A, Simpson KR, Spetz J .
Psychometric properties of The Perinatal Missed Care Survey and missed care during labor and birth.
Appl Nurs Res 2022 Feb;63:151516. doi: 10.1016/j.apnr.2021.151516..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Women
Tilden EL, Phillippi JC, Ahlberg M
Describing latent phase duration and associated characteristics among 1281 low-risk women in spontaneous labor.
Recent research suggests that latent phase of labor may terminate at 6 rather than 4 centimeters of cervical dilation. The objectives of this study were to: (a) characterize duration of the latent phase of labor among term, low-risk, United States women in spontaneous labor using the women's self-identified onset; and (b) quantify associations between demographic and maternal/newborn health characteristics and the duration of the latent phase.
AHRQ-funded; HS024733.
Citation: Tilden EL, Phillippi JC, Ahlberg M .
Describing latent phase duration and associated characteristics among 1281 low-risk women in spontaneous labor.
Birth 2019 Dec;46(4):592-601. doi: 10.1111/birt.12428..
Keywords: Labor and Delivery, Pregnancy, Women
Tan M, Lipman S, Lee H
Evaluation of electronic medical records on nurses' time allocation during cesarean delivery.
The impact of the electronic medical record (EMR) on nursing workload is not well understood. The objective of this descriptive study was to measure the actual and perceived time that nurses spend on the EMR in the operating room during cesarean births. The investigators found that on average, nurses spent 40% of their intraoperative time on the EMR during cesarean births, and this time burden was distributed across the perioperative period.
AHRQ-funded; HS023506.
Citation: Tan M, Lipman S, Lee H .
Evaluation of electronic medical records on nurses' time allocation during cesarean delivery.
J Patient Saf 2019 Dec;15(4):e82-e85. doi: 10.1097/pts.0000000000000467..
Keywords: Electronic Health Records (EHRs), Labor and Delivery, Provider: Nurse, Health Information Technology (HIT), Provider, Pregnancy
Neal JL, Carlson NS, Phillippi JC
Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: a Consortium on Safe Labor study.
This study compared labor care and birth outcomes between medical centers with interprofessional care (midwives and physicians) versus noninterprofessional care (physicians only). A retrospective cohort study was conducted using Consortium on Safe labor data from low-risk nulliparous women who birthed in interprofessional (7393) or noninterprofessional (6982). Women at interprofessional medical centers were 74% less likely to undergo labor induction and 75% less likely to have oxytocin augmentation. In addition, the cesarean rate was 12% lower.
AHRQ-funded; HS024733.
Citation: Neal JL, Carlson NS, Phillippi JC .
Midwifery presence in United States medical centers and labor care and birth outcomes among low-risk nulliparous women: a Consortium on Safe Labor study.
Birth 2019 Nov 11;46(3):475-86. doi: 10.1111/birt.12407..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Women, Outcomes
Lewkowitz AK, Rosenbloom JI, Keller M
Association between stillbirth >/=23 weeks gestation and acute psychiatric illness within 1 year of delivery.
This study analyzed whether women experiencing a stillbirth had a higher risk of psychiatric morbidity and/or substance misuse within 1 year of delivery compared to women having a live birth. Higher risk was found for both using data from the Florida State Inpatient and State Emergency Department databases from 2005-2014. Women with an ICD-9 classification of stillbirth at or greater than 23 weeks gestation were included. Emergency department encounters or admissions with a diagnosis code of a psychiatric disorder were used.
AHRQ-funded; HS019455.
Citation: Lewkowitz AK, Rosenbloom JI, Keller M .
Association between stillbirth >/=23 weeks gestation and acute psychiatric illness within 1 year of delivery.
Am J Obstet Gynecol 2019 Nov;221(5):491.e1-91.e22. doi: 10.1016/j.ajog.2019.06.027..
Keywords: Healthcare Cost and Utilization Project (HCUP), Maternal Care, Pregnancy, Behavioral Health, Women, Labor and Delivery
Carlson NS, Neal JL, Tilden EL
Influence of midwifery presence in United States centers on labor care and outcomes of low-risk parous women: a Consortium on Safe Labor study.
The authors analyzed the association between midwifery presence in maternity care teams and the birth processes and outcomes of low-risk parous women. They found that parous women have significantly higher rates of vaginal birth, including vaginal birth after cesarean, and a lower likelihood of labor induction when cared for in centers with midwives. They concluded that their findings support integrated, team-based models of perinatal care to improve maternal outcomes.
AHRQ-funded; HS024733.
Citation: Carlson NS, Neal JL, Tilden EL .
Influence of midwifery presence in United States centers on labor care and outcomes of low-risk parous women: a Consortium on Safe Labor study.
Birth 2019 Sep;46(3):487-99. doi: 10.1111/birt.12405..
Keywords: Labor and Delivery, Pregnancy, Maternal Care, Women, Outcomes
Carter EB, Cahill AG, Olsen MA
Practical considerations with 17-Hydroxyprogesterone caproate for preterm birth prevention: does timing of initiation and compliance matter?
This study examined whether early initiation and compliance with use of 17-OHPC can reduce the risk of preterm birth (PTB) risk more than later medication initiation. A retrospective cohort study was conducted using MarketScan® data. Rates of PTB were compared for women with medication initiation at 16-21 weeks versus 21-29 weeks. Women with an early 17-OHPC start were less likely to delivery preterm than those with a later start. Less compliant patients also had a higher PTB rate.
AHRQ-funded; HS019455.
Citation: Carter EB, Cahill AG, Olsen MA .
Practical considerations with 17-Hydroxyprogesterone caproate for preterm birth prevention: does timing of initiation and compliance matter?
J Perinatol 2019 Sep;39(9):1182-89. doi: 10.1038/s41372-019-0401-2..
Keywords: Pregnancy, Labor and Delivery, Women, Medication, Patient Adherence/Compliance
Brenes-Monge A, Saavedra-Avendano B, Alcalde-Rabanal J
Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition.
Researchers conducted a cross-sectional study to test the association between overweight and obesity and cesarean delivery in Mexico using data from the 2012 National Survey of Health and Nutrition (ENSANUT). They found that multiparous women with obesity are at higher risk of cesarean delivery in Mexico than multiparous women with normal body mass index. They recommend that efforts to reduce the cesarean deliveries rate take the obesity epidemic into account.
AHRQ-funded; HS022981.
Citation: Brenes-Monge A, Saavedra-Avendano B, Alcalde-Rabanal J .
Are overweight and obesity associated with increased risk of cesarean delivery in Mexico? A cross-sectional study from the National Survey of Health and Nutrition.
BMC Pregnancy Childbirth 2019 Jul 11;19(1):239. doi: 10.1186/s12884-019-2393-5..
Keywords: Labor and Delivery, Obesity, Pregnancy, Risk, Women
Simpson KR, Lyndon A, Spetz J
Adaptation of the MISSCARE Survey to the maternity care setting.
This paper examines the feasibility of using the Missed Nursing Care (MISSCARE) Survey to study missed nursing care during labor and delivery. This survey has not been used to examine childbirth care although it is the most common reason for hospitalization in the United States. A modified version called the Perinatal Missed Care Survey appears to be the most feasible and promising instrument to evaluate missed nursing care during labor and delivery.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Adaptation of the MISSCARE Survey to the maternity care setting.
J Obstet Gynecol Neonatal Nurs 2019 Jul;48(4):456-67. doi: 10.1016/j.jogn.2019.05.005..
Keywords: Labor and Delivery, Maternal Care, Nursing, Pregnancy, Women
Triebwasser JE, Kamdar NS, Langen ES
Hospital contribution to variation in rates of vaginal birth after cesarean.
The purpose of this retrospective cohort study was to determine the influence of delivery hospital on the rate of vaginal birth after cesarean (VBAC). Claims data were obtained from Blue Cross and Blue Shield of Michigan and included women with a prior cesarean and a singleton live birth. Hospital-specific risk-standardized VBAC rates and the median odds ratio as a measure of variation were calculated. From their results, the authors conclude that the individual delivery hospital contributes to the significant variation in rates of VBAC, after adjustment for patient and hospital characteristics.
AHRQ-funded; HS025465.
Citation: Triebwasser JE, Kamdar NS, Langen ES .
Hospital contribution to variation in rates of vaginal birth after cesarean.
J Perinatol 2019 Jul;39(7):904-10. doi: 10.1038/s41372-019-0373-2..
Keywords: Hospitals, Labor and Delivery, Maternal Care, Pregnancy, Women
Guglielminotti J, Landau R, Li. G
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Compared with neuraxial anesthesia, general anesthesia for cesarean delivery is associated with increased risk of maternal adverse events. Reducing avoidable general anesthetics for cesarean delivery may improve safety of obstetric anesthesia care. This study examined adverse events, trends, and factors associated with potentially avoidable general anesthetics for cesarean delivery. The investigators concluded that compared with neuraxial anesthesia, avoidable general anesthetics are associated with increased risk of adverse maternal outcomes.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Landau R, Li. G .
Adverse events and factors associated with potentially avoidable use of general anesthesia in cesarean deliveries.
Anesthesiology 2019 Jun;130(6):912-22. doi: 10.1097/aln.0000000000002629..
Keywords: Healthcare Cost and Utilization Project (HCUP), Labor and Delivery, Surgery, Pregnancy, Adverse Drug Events (ADE), Adverse Events, Women, Medication, Medication: Safety, Patient Safety, Maternal Care
Simpson KR, Lyndon A, Spetz J
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Labor and delivery nurses were surveyed to determine if their units adhere to Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) staffing guidelines. Labor nurses in selected hospitals in California, Michigan and New Jersey were invited via email to participate in the study. Their nurse leaders facilitated the invitations. A total of 615 labor nurses from 67 hospitals participated. Most nurses did report that staffing guidelines were adhered to. The hospitals with smaller annual birth volumes (500-999 range) were significantly more like to be perceived as compliant than hospitals with 2,500 or more annual births.
AHRQ-funded; HS025715.
Citation: Simpson KR, Lyndon A, Spetz J .
Adherence to the AWHONN staffing guidelines as perceived by labor nurses.
Nurs Womens Health 2019 Jun;23(3):217-23. doi: 10.1016/j.nwh.2019.03.003..
Keywords: Care Management, Guidelines, Labor and Delivery, Maternal Care, Patient Safety, Pregnancy, Provider, Provider: Nurse, Women
Vanderlaan J, Rochat R, Williams B
Associations between hospital maternal service level and delivery outcomes.
This study explored the associations between delivery hospital self-reported level of maternal service, as defined by the American Hospital Association, and both maternal and neonatal outcomes among women at high maternal risk, as defined by the Obstetric Comorbidity Index. The investigators concluded that for the group of pregnant women in need of maternal transfer, delivery hospital self-reported level of maternal care was not associated with the odds of poor maternal or neonatal outcomes.
AHRQ-funded; HS024655.
Citation: Vanderlaan J, Rochat R, Williams B .
Associations between hospital maternal service level and delivery outcomes.
Womens Health Issues 2019 May - Jun;29(3):252-58. doi: 10.1016/j.whi.2019.02.004..
Keywords: Maternal Care, Labor and Delivery, Pregnancy, Women, Outcomes, Hospitals, Quality of Care, Newborns/Infants, Mortality
Lapcharoensap W, Cong A, Sherman J
Safety and ergonomic challenges of ventilating a premature infant during delayed cord clamping.
This study discussed the reasons that delayed cord clamping (DCC) for term and preterm infants is endorsed by multiple medical organizations. It has been shown to reduce hemorrhage, lower incidence of necrotizing enterocolitis and the need for transfusions in preterm infants. The writers held a number of multidisciplinary simulation workshops of vaginal and Caesarean deliveries, with providers starting positive pressure ventilation and ending with CPAP on a preterm manikin. Videos were also reviewed and identified 5 themes of concern: sterility, equipment, mobility, space, and workflow.
AHRQ-funded; HS023506.
Citation: Lapcharoensap W, Cong A, Sherman J .
Safety and ergonomic challenges of ventilating a premature infant during delayed cord clamping.
Children 2019 Apr 13;6(4). doi: 10.3390/children6040059..
Keywords: Adverse Events, Labor and Delivery, Newborns/Infants, Patient Safety
Kahwati LC, Sorensen AV, Teixeira-Poit S
AHRQ Author: Mistry KB
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
The purpose of this study was to describe the Safety Program for Perinatal Care (SPPC) implementation experience and evaluate the short-term impact on labor and delivery (L&D) unit patient safety culture, processes, and adverse events. SPPC implementation by L&D units were supported sing a program toolkit, trainings, and technical assistance. Researchers then evaluated the program using a pre-post, mixed-methods design. Changes in safety and quality were measured using the Modified Adverse Outcome Index (MAOI) and other perinatal care indicators. Findings showed that SPPC had a favorable impact on unit patient safety culture and processes, but mixed short-term impact on maternal and neonatal adverse events.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Kahwati LC, Sorensen AV, Teixeira-Poit S .
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):231-40. doi: 10.1016/j.jcjq.2018.11.002..
Keywords: Adverse Events, Communication, Comprehensive Unit-based Safety Program (CUSP), Labor and Delivery, Maternal Care, Newborns/Infants, Outcomes, Patient Safety, Pregnancy, Simulation, Surveys on Patient Safety Culture, Teams, TeamSTEPPS, Training, Women
Milla C, Guo M, Chang A
Patient perspectives in comparing hospitals for childbirth: insights from Hawai'i.
Childbirth is a national priority area for healthcare quality improvement. Patient perspectives are increasingly valued in healthcare, yet Asian American and Pacific Islander (AAPI) perspectives of healthcare quality are often understudied, particularly from individuals with limited English proficiency (LEP). In this study, the goal was to understand factors that consumers in Hawai'i, including AAPI and those with LEP, used to compare patient care in hospitals, especially for childbirth.
AHRQ-funded; HS021903.
Citation: Milla C, Guo M, Chang A .
Patient perspectives in comparing hospitals for childbirth: insights from Hawai'i.
Hawaii J Med Public Health 2019 Mar;78(3):89-97..
Keywords: Labor and Delivery, Pregnancy, Hospitals, Quality Improvement, Quality of Care, Cultural Competence, Women
Gourevitch RA, Mehrotra A, Galvin G
Does comparing cesarean delivery rates influence women's choice of obstetric hospital?
This study examined whether pregnant women who use cesarean delivery rate data from hospitals influences their choice of obstetric hospital. A randomized controlled trial of 18,293 users of the Ovia Health mobile app from 2016-2017 was conducted. Enrollees were given an explanation of the cesarean rate data and were randomized to an intervention group who also were given an interactive tool to display data for the 10 closest hospitals with obstetric services. There was no significant difference between the intervention and control groups in their hospital selection.
AHRQ-funded; HS000055.
Citation: Gourevitch RA, Mehrotra A, Galvin G .
Does comparing cesarean delivery rates influence women's choice of obstetric hospital?
Am J Manag Care 2019 Feb;25(2):e33-e38..
Keywords: Pregnancy, Women, Hospitals, Maternal Care, Labor and Delivery
Xu X, Lee HC, Lin H
Hospital variation in utilization and success of trial of labor after a prior cesarean.
The purpose of this study was to examine hospital variation in utilization and success of trial of labor after cesarean delivery (TOLAC) and to identify associated institutional characteristics and patient outcomes. The investigators found that utilization and success rates of TOLAC varied considerably across hospitals. Strategies to promote vaginal birth should be tailored to hospital needs and characteristics (e.g., increase availability at low TOLAC rate hospitals while being more selective at high TOLAC rate hospitals, and targeted support for lower capacity hospitals).
AHRQ-funded; HS023801.
Citation: Xu X, Lee HC, Lin H .
Hospital variation in utilization and success of trial of labor after a prior cesarean.
Am J Obstet Gynecol 2019 Jan;220(1):98.e1-98.e14. doi: 10.1016/j.ajog.2018.09.034.
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Keywords: Labor and Delivery, Pregnancy, Women