A quality-improvement project carried out in five Florida hospitals resulted in a dramatic 83 percent decline in early elective deliveries, with the goal of improving the health and development of babies by preventing unnecessary early c-sections or inductions.
The study, which was a collaborative effort by March of Dimes, academic health centers and state health departments, educated doctors and patients on the benefits of waiting for delivery until at least the 39th week of pregnancy, and through these efforts reduced the rate of early scheduled births from 28.8 percent to 4.8 percent in participating hospitals.
“Reducing unnecessary early deliveries to less than 5 percent means that more babies stayed in the womb longer, which is so important for their growth and development,” said another author, Dr. William M. Sappenfield of University of South Florida.
Florida accounts for approximately 5 percent of the nation’s births, but has one of the nation’s highest rates of early scheduled deliveries. In 2011, the average rate for early elective deliveries in Florida was 13.2 percent, increasing to 18.2 percent in 2012. This increase runs contrary to national trends showing overall decreases in elective c-sections, according to a Leapfrog report in Health News Florida. There are health consequences for these decisions — and economic consequences as well. According to the federal AHRQ, vaginal delivery without complications averaged $2,900 and a 2.1 day hospital stay in 2008, while a c-section without complications averaged $4,700 and a 3.1 day hospital stay. These differences may not be huge for an individual but account for billions of dollars in costs annually.
Participating Florida hospitals included Lee Memorial Health System (Ft. Myers), Santa Rosa Medical Center (Milton), South Miami Hospital, Broward Health Medical Center (Ft. Lauderdale), and St. Josephs Women’s Hospital (Tampa). They were joined by 20 other hospitals in California, Texas, New York and Illinois.
This study demonstrates the efficacy of education in developing quality improvement measures.