Employers Call for Illinois Hospitals and Physicians
to Reduce Early Elective Deliveries
Cary Conway, MBGH Media Contact
CHICAGO – The non-profit Midwest Business Group on Health (MBGH) issued a call to action in response to recent data finding that thousands of babies are electively scheduled for delivery too early, especially for non-medical reasons, resulting in a higher likelihood of death, being admitted to a Neonatal Intensive Care Unit (NICU) and life-long health problems. MBGH joins The Leapfrog Group and Chicago-area hospitals, health plans and other stakeholders in making this call to action.
“Hospitals need to look at their data and proactively reach out to medical staff members to discuss developing policies to reduce non-medically-related early elective deliveries that can result in small, underdeveloped infants with serious and expensive health consequences,” said Larry Boress, MBGH president and CEO. “By shining a light on this problem, we encourage physicians to advise patients desiring early deliveries for convenience reasons of the serious ramifications of such actions. In turn, we encourage women to talk with their physicians to avoid early elective deliveries for convenience of the doctor.”
The employer-driven hospital quality watchdog, The Leapfrog Group, recently released data demonstrating a variation of 5-40% among hospitals nationally that allow early deliveries for non-medical reasons. In 2010, Leapfrog’s annual hospital survey collected data on the number of non-medically indicated deliveries occurring between the 37th and 39th week of gestation. It set a target cesarean section and/or induction rate of less than 12% of the total. Nationally, the average rate was 18%, while among Illinois hospitals reporting this data, the state average for these types of deliveries was 23%. Leapfrog found 29% of reporting hospitals were addressing this situation and reported non-medically related early delivery rates of 5% or less.
Jerry Custer, Executive Director of the Peoria-area Heartland Healthcare Coalition noted that “While some hospitals within the state are doing an excellent job of keeping their rates low, we support the need for others to put more effort and emphasis on this issue.” Experts, including those from the American College of Obstetricians and Gynecologists (ACOG), Childbirth Connection and the March of Dimes, caution that the amount of time a baby needs to develop fully, which includes having a fully developed brain and other organs, is at least 39 completed weeks. Sometimes there is a medical reason to schedule a newborn delivery before the 39th week — for example, if a woman has high blood pressure at the end of her pregnancy or broken membranes before labor begins.
“Based on ongoing review of our own data as well as Leapfrog’s study, we know reducing the overall number of elective caesarean sections will translate to fewer NICU admissions and fewer health complications for newborns,” said Tina Groat, M.D., national medical director of Women’s Health for UnitedHealthcare. “The difference of health outcomes between 37 weeks gestation and 39 can be alarming, and we are eager to get this important message out.”
The early delivery Leapfrog survey measure is endorsed by the National Quality Forum, an organization tasked with bringing together experts and stakeholders to come to consensus on national measures of hospital quality and safety. Hospital rates of elective deliveries scheduled too early are now available for easier viewing on this special website: www.leapfroggroup.org/tooearlydeliveries. Leapfrog’s release of 2010 data is the first real evidence that the practice of scheduling newborn deliveries before 39 weeks without a medical reason is common and varies among hospitals even in the same state or community.
“I’m supportive of efforts to increase the understanding of this important issue, and to push for improvement. It is entirely consistent with Advocate Health Care’s policy on elective deliveries,” said Lee Sacks, MD, Executive Vice President and Chief Medical Officer for Advocate Health Care.
"CIGNA joined The Leapfrog Group's Call to Action to reduce the number of elective births prior to term and supports MBGH’s initiative to raise awareness and lower the rate of unnecessary deliveries before the 39th week in Illinois," said Sue Podbielski, president, CIGNA HealthCare Midwest Markets. "As a long-standing partner of the March of Dimes, we’re advocates for healthy pregnancies and healthy babies—and we’re seeing positive results. In 2009, the March of Dimes announced a 3% reduction in premature births which means 14,000 families brought home a new baby without any added fear or worry.”
In the next few months, MBGH will be inviting interested groups to participate in discussions on how hospitals, physicians, patients, health plans and employers can work together to better understand why early deliveries exist and how to address and reduce these. For more information, contact Larry Boress.
About The Leapfrog Group
The Leapfrog Group is a coalition of public and private purchasers of employee health benefits founded a decade ago to work for improvements in health care safety, quality, and affordability. Maternal/Child care represents a major component of health benefits programs, and Leapfrog's purchaser members share concerns about the quality of obstetrics and neonatal intensive care. Early elective deliveries represent a significant cost in health care, with one study estimating that nearly $1 billion dollars could be saved annually in the U.S. if the rate of early elective deliveries were reduced to 1.7%. 2010 Leapfrog Hospital Survey Results for over 1200 hospitals can be found at www.leapfroggroup.org/cp.
About the Midwest Business Group on Health
Celebrating more than 30 years of advancing value in health care and health benefits management, the non-profit Midwest Business Group on Health (MBGH) is one of the nation's leading business groups of private and public employers. MBGH's more than 100 members represent over 3 million lives, spending more than $3 billion on health care benefits annually. MBGH member benefits include educational workshops for health benefits management, networking opportunities, research, demonstration projects and community initiatives. MBGH is a founding member of the National Business Coalition on Health.