Using publicly reported hospital data to predict obstetric quality.
OBJECTIVE
To determine the association between obstetric outcomes and publicly reported hospital data on patient satisfaction, surgical quality measures and medical outcomes.


METHODS
Hospitals in the Nationwide Inpatient Sample in 2011 were linked to Hospital Compare, a source of hospital data on patient satisfaction, quality and mortality for medical conditions. The risk-adjusted hospital-level rates of obstetric morbidity, episiotomy and lacerations were compared across the hospitals and reported as the absolute reduction in risk (ARR).


RESULTS
We identified 528 708 women. There was no association between any of the metrics and risk-adjusted obstetric morbidity (range -0.15% to 0.03% difference). Hospitals with a high mortality rate for pneumonia had a 0.38% (95% CI: 0.13% to 0.64%) higher rate of risk-adjusted third- and fourth-degree lacerations, while hospitals with a higher death rate for myocardial infarction had a -0.74% (95% CI, -1.34% to -0.14%) lower risk-adjusted episiotomy rate. The differences in the remainder of the publicly reported metrics and the risk adjusted rates of third- and fourth-degree lacerations and episiotomy were small and not statistically significant (p  > 0.05).


CONCLUSIONS
There is little association between currently available, publically reported hospital data and obstetric quality. Obstetric-specific hospital measures of quality and satisfaction are needed.
a Department of Obstetrics and Gynecology , Columbia University College of Physicians and Surgeons , New York , NY , USA.|b New York Presbyterian Hospital , New York , NY , USA.
Shravya
S
Govindappagari
a Department of Obstetrics and Gynecology , Columbia University College of Physicians and Surgeons , New York , NY , USA.|b New York Presbyterian Hospital , New York , NY , USA.
Alexander M
AM
Friedman
a Department of Obstetrics and Gynecology , Columbia University College of Physicians and Surgeons , New York , NY , USA.
Ling
L
Chen
a Department of Obstetrics and Gynecology , Columbia University College of Physicians and Surgeons , New York , NY , USA.|c Department of Epidemiology , Joseph L. Mailman School of Public Health, Columbia University , New York , NY , USA , and.
Cande V
CV
Ananth
a Department of Obstetrics and Gynecology , Columbia University College of Physicians and Surgeons , New York , NY , USA.|b New York Presbyterian Hospital , New York , NY , USA.
Mary E
ME
D'Alton
b New York Presbyterian Hospital , New York , NY , USA.|c Department of Epidemiology , Joseph L. Mailman School of Public Health, Columbia University , New York , NY , USA , and.|d Department of Medicine , Columbia University College of Physicians and Surgeons , New York , NY , USA.
Dawn L
DL
Hershman
a Department of Obstetrics and Gynecology , Columbia University College of Physicians and Surgeons , New York , NY , USA.|b New York Presbyterian Hospital , New York , NY , USA.
Jason D
JD
Wright
D000293:Adolescent; D000328:Adult; D005260:Female; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D009774:Obstetrics / Q000592:standards* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011247:Pregnancy; D019984:Quality Indicators, Health Care; D055815:Young Adult
Hospital Compare; Obstetrics; quality; satisfaction