Hospital variation in cost of childbirth and contributing factors: a cross-sectional study

BJOG : an International Journal of Obstetrics and Gynaecology
X XuJessica L Illuzzi

Abstract

To examine hospital variation in cost of childbirth hospitalisations and identify factors that contribute to the variation. Cross-sectional analysis of linked birth certificate and hospital discharge data. Two hundred and twenty hospitals in California delivering ≥ 100 births per year. A total of 405 908 nulliparous term singleton vertex births during 2010-2012. Cost of childbirth hospitalisations was compared across hospitals after accounting for differences in patient clinical risk factors. Relative contributions of patient sociodemographic, obstetric intervention, birth attendant and institutional characteristics to variation in cost were assessed by further adjusting for these factors in hierarchical generalised linear models. Cost of childbirth hospitalisation. Median risk-standardised cost of childbirth was $7149 among the hospitals (10th -90th percentile range: $4760-$10,644). Maternal sociodemographic characteristics and type of birth attendant did not explain hospital variation in cost. Adjustment for obstetric interventions overall reduced within-hospital variance by 15.8% (P < 0.001), while adjusting for caesarean delivery alone reduced within-hospital variance by 14.4% (P < 0.001). However, obstetric interventions d...Continue Reading

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Citations

Feb 26, 2019·Obstetrics and Gynecology·Leanna Sudhof, Neel T Shah
Apr 3, 2021·Journal of Neurosurgery. Pediatrics·Shenae SamuelsHeather Spader

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