C-section rates in US stabilize after eight years of steady increase

A new report on trends in women's health in the United States reveals the national C-section rate has held steady at 33 percent since 2009, leveling off after eight years of steady increase that was in part driven by scheduled, elective surgeries and a trend for increasing the repeat C-section. The report, published today by Healthgrades, the leading provider of information to help consumers make an informed decision about a physician or hospital, also found several disparities in healthcare between men and women.

Among the findings:

• While the rate of surgical intervention for both male and female cardiac patients has risen in recent years, only 39.5 percent of women received surgical treatment compared to 54.3 percent of men in 2010 – continuing a trend that Healthgrades has seen over the past several years.
• Among those patients, the mortality rate was 29.1 percent higher among women
• Women were admitted to the hospital for hip fractures at approximately twice the rate of men from 2008-2010.

Healthgrades also tracked trends in common gynecologic and maternity care procedures for women in the United States. Among the findings:

• Hysterectomies continued to decrease in frequency between 2008 and 2010. Across the 19 states studied, there was a 21 percent decrease in hysterectomies performed, from 267,077 in 2008 to 211,062 in 2010. The decrease may be due to economic factors driving patients' decision to delay this generally elective procedure.
• Florida and New Jersey continued to have the highest C-section rates since Healthgrades' last report on the procedure, while Utah and Wisconsin maintained the lowest rates.

"We are encouraged to see C-section rates stabilize, which indicates women are learning more about their choices and discussing them with their obstetricians. But life-saving interventions among female heart attack patients continues to be a challenge which presents an opportunity for physicians and patients to become better versed in recognizing and treating cardiac conditions," said Divya Cantor, MD, MBA, Healthgrades senior physician consultant and the study's author. "Overall, our findings underscore the importance for females to research, select, and communicate with the right physicians and hospitals for their needs."

Healthgrades conducted the study, Healthgrades 2012 Trends in Women's Health in American Hospitals, as part of its annual process for identifying 5-star rated hospitals for women's health, maternity care and gynecologic surgery, and for identifying recipients of the Healthgrades 2012 Women's Health Excellence Award™, Healthgrades 2012 Gynecologic Surgery Excellence Award™, and Healthgrades 2012 Maternity Care Excellence Award™.

"Healthgrades is committed not only to facilitating this critical education and communication, but also to identifying top hospitals for female patients," Dr. Cantor continued. "The hospitals recognized by Healthgrades for excellence in Women's Health, Maternity Care and Gynecologic Surgery have set a national standard for superior care for the mothers, wives, sisters and daughters in their communities."

This year, 176 hospitals received the Women's Health Excellence Award; 461 hospitals received a 5-star rating in Gynecologic Surgery; and 224 hospitals received a 5-star rating in Maternity Care. Only seven hospitals received all three awards.

To identify the 2012 Women's Health Excellence Award recipients, Healthgrades examined hospitalization records from the MedPAR database in all 50 states, for the years 2008 through 2010. The following procedures and treatments were analyzed: heart attack, congestive heart failure, pneumonia, chronic obstructive pulmonary disease, stroke, coronary bypass surgery, peripheral vascular bypass, coronary interventional procedures, resection/replacement of abdominal aorta, carotid surgery, and valve replacement; total knee and hip replacement surgeries, spinal surgeries, and hip fracture repair.

For both maternity care and gynecologic surgery, Healthgrades used three years of data, (2008 through 2010) from 19 states where hospital patient outcomes data are publicly available. The best-performing hospitals received 5 stars, average‐performing hospitals received 3 stars, and poor-performing hospitals received 1 star.