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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
David A Webb, PhD, Philadelphia Department of Public Health, 500 S. Broad Street, Philadelphia, PA 19146, (215)685-6845, David.Webb@phila.gov and Jennifer F culhane, Obsbtetrics and Gynecology, Thomas Jefferson University Hospital, 1012 Walnut St, Philadelphia, PA 19104.
Objective: To assess the extent and nature of hospital variation in reported levels of infection following Cesarean delivery, independent of "patient mix" or individual-level risk factors. Study Design: Population-based study using linked birth and hospital discharge records pertaining to almost 10,000 Philadelphia resident Cesarean deliveries occurring over a six-year period in 18 area hospitals. Results. Reported incidences of infection varied greatly from a high of 2058 to a low of 37 per 10,000, even after women with preexisting risk factors for postoperative infection were excluded from the analyses. Logistic regression results also indicated that other maternal and infant characteristics do not account for such variation. Hospital charges and maternal length of stay were strongly correlated with the frequency of infection diagnosis. Conclusions. Hospital practices may be driving large discrepancies with respect to the risk and/or diagnosis of postoperative infection; thus, treatment and the costs of care associated with cesarean delivery are highly variable from one hospital to the next.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.