How Best to Capture Quality of Obstetric Care?

Performance on two Joint Commission obstetric quality indicators had no bearing on maternal or neonatal complication rates.

Documenting quality of obstetric care has been a vexing issue. The Agency for Healthcare Research and Quality considers only the number of prenatal visits, and the Joint Commission recommends two perinatal quality measures: rate of elective delivery before 39 weeks' gestation and prevalence of cesarean delivery in low-risk nulliparous women (those with singleton, term fetuses in cephalic presentation). Investigators assessed the performance of these two measures against the likelihood of severe maternal or neonatal morbidity in all New York City hospitals in 2010.

Among >115,000 deliveries, 2.4% and 7.5% were associated with severe maternal or neonatal morbidity, respectively. Median rate of elective delivery before 39 weeks was 28% (range a…

Reviewing Author

Allison Bryant, MD, MPH

Disclosures

RoyaltiesUpToDate

Leadership Positions in Professional SocietiesSociety for Maternal-Fetal Medicine (Board of Directors)

Allison Bryant, MD, MPH

Disclosures

RoyaltiesUpToDate

Leadership Positions in Professional SocietiesSociety for Maternal-Fetal Medicine (Board of Directors)

How Best to Capture Quality of Obstetric Care?

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Reviewing Author