Determinants of hospital charges associated with childbirth

Background: We investigated the factors associated with hospital delivery costs. With the passage of health care reform, it is important to learn about the factors that increase childbirth-associated hospital costs.

Methods: 3,006 pregnant women, 18 to 36 years old, and expecting their first child in 2009 to early 2011, were interviewed in Pennsylvania in their third trimester and at one month postpartum. Ordinary Least Squares analysis was performed with the natural log of total hospital charges as the dependent variable. Data on total hospital charges came from inpatient discharge data.

Results: The women averaged 27 years old, 86% were white, 57% had a college degree, and 29% had a cesarean delivery. The highest average hospital charges were specialty and room and board charges followed by ancillary, drug, equipment, and miscellaneous charges, respectively. In multivariate analyses, variables associated with increased hospital charges were: being non-white, obese, older, delivering by cesarean section, experiencing delivery complications, and having baby complications. Women who gave birth by cesarean section incurred 72.5% higher hospital charges than those who delivered vaginally and women who experienced delivery complications incurred 14% higher hospital charges than those who had no complications.

Conclusions: With health care reform, states will be trying to save on their hospital costs as their Medicaid programs expand and they will have to cover more maternity services such as birth center fees. Learning about the factors that increase hospital charges related to childbirth may help states with their efforts to decrease hospital costs.