The association between hospital obstetrical volume and maternal postpartum complications

Kathy L. Kyser, Xin Lu, Donna A. Santillan, Mark K. Santillan, Stephen K. Hunter, Alison G. Cahill, Peter Cram

Research output: Contribution to journalArticlepeer-review

64 Scopus citations

Abstract

OBJECTIVE: The purpose of this study was to examine the relationship between delivery volume and maternal complications. STUDY DESIGN: We used administrative data to identify women who had been admitted for childbirth in 2006. Hospitals were stratified into deciles that were based on delivery volume. We compared composite complication rates across deciles. RESULTS: We evaluated 1,683,754 childbirths in 1045 hospitals. Decile 1 and 2 hospitals had significantly higher rates of composite complications than decile 10 (11.8% and 10.1% vs 8.5%, respectively; P < .0001). Decile 9 and 10 hospitals had modestly higher composite complications as compared with decile 6 (8.8% and 8.5% vs 7.6%, respectively; P < .0001). Sixty percent of decile 1 and 2 hospitals were located within 25 miles of the nearest greater volume hospital. CONCLUSION: Women who deliver at very low-volume hospitals have higher complication rates, as do women who deliver at exceedingly high-volume hospitals. Most women who deliver in extremely low-volume hospitals have a higher volume hospital located within 25 miles.

Original languageEnglish (US)
Pages (from-to)42.e1-42.e17
JournalAmerican journal of obstetrics and gynecology
Volume207
Issue number1
DOIs
StatePublished - Jul 2012
Externally publishedYes

Keywords

  • complication
  • obstetrical volume
  • patient safety

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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