Measures of performance in Scottish maternity hospitals.
OBJECTIVE
To develop measures of hospital performance over time with particular reference to maternal and neonatal care by controlling for case mix.


METHODS
Analysis of computerised records of births.


METHODS
Scotland, 1980-7.


METHODS
Over half a million singleton live births and stillbirths.


METHODS
Numbers of perinatal deaths and caesarean sections.


RESULTS
Scottish maternity hospitals perform more or less equally with regard to perinatal mortality. When caesarean sections are considered, there is evidence that hospitals differ in their treatment of different groups of women; in two examples one hospital had an increased rate among women of parity 2 or more and another had a reduced rate of repeat caesarean section.


CONCLUSIONS
Developing measures of performance over time by controlling for case mix is a valid system for monitoring hospital outcomes and activity, and allows comparison either between hospitals or with data for all Scottish maternity hospitals. Hospital profiles permit identification of differences for particular patient groups after allowance is made for other case mix variables.
Leyland
A H
AH
Social Paediatric and Obstetric Research Unit, University of Glasgow.
Pritchard
C W
CW
McLoone
P
P
Boddy
F A
FA
D000328:Adult; D000465:Algorithms; D002585:Cesarean Section / Q000706:statistics & numerical data; D003953:Diagnosis-Related Groups; D005260:Female; D017052:Hospital Mortality; D006771:Hospitals, Maternity / Q000592:standards*; D006801:Humans; D007224:Infant Care / Q000592:standards*; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011247:Pregnancy; D012307:Risk Factors; D012606:Scotland