Do High-Risk Obstetric Patients Fare Better in High-Volume Centers?

The relation between a hospital's delivery volume and its quality of care (measured by patient outcomes) remains unclear, as previous investigations have focused on women at low risk for adverse outcomes. Nevertheless, severe maternal morbidity is largely borne by women at greater a priori risk. Where are such women best served in childbirth? Investigators used linked California birth and hospital records to identify a cohort of women at high risk for surgical or medical morbidity then determined maternal outcomes stratified by overall, as well as high-risk, delivery volume of the hospitals at which these women gave birth. The study population included 142,000 high-risk surgical patients and 1.3 million high-risk medical patients.

After cont…