Cesarean Rates for Washington State Hospitals  - 2006

 

Charts below: 

Rankings: Seattle area hospitals 2006, ranked from lowest to highest cesarean rate

Trends over time: Seattle area hospitals, 2003 – 2006

Alphabetical: All Washington state hospitals, 2006

 

Rankings: Seattle area hospitals, ranked from lowest to highest cesarean rate

 

total births

total c-s

c-s rate

rank

Group Health Central Hospital

1,400

327

23%

1

Stevens Healthcare

1,199

327

27%

2

Northwest Hospital

994

299

30%

3

Providence Everett Medical Center

3,683

1091

30%

4

Auburn Regional Medical Center

943

293

31%

5

Swedish Medical Center

7,472

2309

31%

6

Highline Community Hospital

1,235

397

32%

7

Tacoma General Hospital

3,110

1001

32%

8

Overlake Hospital Medical Center

4,032

1331

33%

9

Valley Medical Center

3,386

1144

34%

10

Evergreen Hospital Medical Center

4,574

1621

35%

11

University Of Washington Med Ctr

2,040

741

36%

12

Data source: Washington State Department of Health, Comprehensive Hospital Abstract Reporting System

http://www.doh.wa.gov/EHSPHL/hospdata/CHARS/2006/2006FullHospitalCensusandChargesbyDRG.xls

Methodology: For total births, tallied DRG categories: 370 – cesarean with complications, 371 – cesarean rate without, 372 – vaginal delivery with complicating conditions, 373 – vaginal delivery without cc, 374 – vaginal delivery with sterilization, 375 – vaginal delivery with OR procedures. The CS total was category 370 + 371. Rate was calculated as CS Total / Total Births.  Rank is a comparison between the hospitals on this list, with 1 being lowest cesarean rate, and 12 being highest. Calculations done by Janelle Durham.

 

Trends over time: Seattle area hospitals, 2003 – 2006, alphabetical

 

 

2003

2004

2005

2006

Auburn

982 / 29.94%

1000 / 32%

996 / 34.4%

943 / 31%

Evergreen

3983 / 29.68%

4303 / 33.7%

4336 / 34.9%

4574 / 35%

Group Health

1311 / 16.55%

1206 / 19.57%

1284 / 19.5%

1400 / 23%

Highline

1316 / 24.09%

1339 / 28.16%

1291 / 27.8%

1235 / 32%

Northwest

992 / 27.82%

980 / 32.14%

999 / 30.9%

994 / 30%

Overlake

3813 / 29.03%

3736 / 30.19%

3780 / 30.7%

4032 / 33%

Stevens

1219 / 24.12%

1138 / 24.96%

1228 / 27%

1199 / 27%

Swedish

 

7025 / 28.44%

7201 / 30.22%

7472 / 31%

UWMC

1843 / 35.81%

1986 / 37.56%

2049 / 36.4%

2040 / 36%

Valley

2456 / 27.12%

2742 / 30.56%

2697 / 29.6%

3386 / 34%

 

Data from CHARS. 2003 and 2004 calculations from http://www.seattlebirthnet.com/stats.html

2005 and 2006 calculations by Janelle Durham
 

What is the recommended rate for cesareans?

CIMS, WHO, and “Healthy People 2010” recommendations are for an overall cesarean rate around 15%. WHO’s research clearly showed that if a developing country does not have sufficient medical resources, and their cesarean rate is below 10%, maternal mortality and infant mortality go up. But, it also showed that if a country’s rate is too high (over 15%), maternal and infant mortality go up.

For the best overview of all the issues surrounding cesarean, see ChildbirthConnection.org

 

Why do rates range so much from birth place to birth place?

Different populations:  Rural hospitals often only accept low-risk clients who are not expected to need substantial interventions, and refer clients who are known to be higher risk to larger, regional hospitals or research/teaching hospitals which have the facilities to deal with potential complications. Therefore, it is natural for these regional hospitals and teaching hospitals to have higher rates of interventions because they serve a higher-risk population.

Different caregiver philosophies/training: Midwives are typically trained to minimize interventions, and typically have lower rates than obstetricians, who are trained surgeons. Thus, birthplaces which use midwives and family practice doctors may have lower rates than hospitals where only physicians practice.

Prevalence of other interventions: Hospital protocols also vary, with some birthplace philosophies leading to lower cesarean rates. Other medical interventions in the labor and birth process may increase the prevalence of cesarean, so if interventions are common at a birthplace, then the cesarean rate may be higher.  For example, induction of labor increases the relative risk of cesarean, so a hospital with a high induction rate would be likely to have a high cesarean rate.

 

These statistics tell the average for a birth place. How would I find out what my doctor or midwife’s rates are?

All the statistics given here are averages amongst all the care providers practicing at a birthplace. If you look at any particular care provider or group of providers, their practices may differ significantly from this average.

The best way to find out about the practices of a specific caregiver is to ask him or her directly. Rather than just asking for his/her rate, ask the caregiver to explain his/her rationale. Ask questions like: what could I do to minimize the chance of needing a cesarean? What do you as the caregiver do to minimize my need for cesarean? How would you decide when it was necessary to perform surgery?

 

Alphabetical: All Washington state hospitals, 2006

 

total births

total c-s

c-s rate

Auburn Regional Medical Center

943

293

31%

Capital Medical Center

791

246

31%

Cascade Valley Hospital

317

103

32%

Central Washington Hospital

1,350

395

29%

Coulee Community Hospital

89

28

31%

Deaconess Medical Center

2,089

676

32%

Enumclaw Community Hospital

211

53

25%

Evergreen Hospital Medical Center

4,574

1621

35%

Forks Community Hospital

101

15

15%

Good Samaritan Hospital

1,946

577

30%

Grays Harbor Community Hospital

565

202

36%

Group Health Central Hospital

1,400

327

23%

Harrison Memorial Hospital

2,049

555

27%

Highline Community Hospital

1,235

397

32%

Holy Family Hospital

1,130