Wednesday, June 23, 1999
Maternity costs, care vary widely
Comparisons provided in 16-site report
BY TIM BONFIELD
The Cincinnati Enquirer
The time women spend in the hospital after having a baby, their chances of having a C-section and the bills they end up paying can vary widely at Tristate maternity units.
A report issued Tuesday by the Health Improvement Collaborative of Greater Cincinnati represents the first public comparison of area maternity services. The study compares 1997 data for 13 hospitals or systems that run a total of 16 maternity units.
The report provides potentially useful information for couples deciding where to have a baby. The data may also help employers compare the hospitals that various health plans offer.
Among the report's highlights:
• Average length of stay for mothers ranged from 1.9 days at McCullough-Hyde Memorial Hospital in Oxford to 2.7 days at Good Samaritan.
• Caesarian-section rates ranged from 16.8 percent of patients at Mercy Franciscan Mount Airy Campus to 25.6 percent at Dearborn County Hospital.
• Charges ranged from $2,786 at Fort Hamilton to $4,078 at St. Elizabeth Medical Center.
• Mortality rates were not detailed, but deaths at all Tristate hospitals fell within “expected levels,” the report said.
The differences among the hospitals are significant because the data were adjusted for the severity of illness. Some hospitals, such as Good Samaritan and University, are known for taking on more high-risk pregnancies.
Good Samaritan, the Tristate's biggest single-site maternity service, also has the area's longest average length of stay.
Even with adjustments for severity, the number of high-risk pregnancies treated at Good Samaritan drove up its average length of stay, said John Sanders, director of perinatal services at TriHealth, the hospital group to which Good Samaritan belongs.
Officials at St. Elizabeth Medical Center were surprised to learn they were listed as the most expensive maternity hospital in town, said spokeswoman Karla Webb.
However, when St. Elizabeth staff looked more closely at their own data they found entry errors and accounting practices that inflated their average charges. For example, some services that should have been charged to the baby were listed as charges to the mother. Those problems will be fixed for future reports, Ms. Webb said.
Most Tristate hospitals came in below the national C-section average of 20.7 percent and below an Ohio average of 19.3 percent.
Hospitals have been under pressure for several years to cut their C-section rates because various studies have shown that doctors perform the expensive procedure more often than necessary.
Of the biggest hospital groups in the report — the Health Alliance of Greater Cincinnati, TriHealth and Mercy Health Partners — the Health Alliance hospitals had consistently high C-section rates.
Four of its five hospitals were above statewide averages, while all of the TriHealth and Mercy hospitals were below state averages.
“We knew at that time that we had some opportunity for improvement,” said Marcia Swehla, director of women's health for the Health Alliance.
The report's main purpose was to help hospitals see where they stand compared with their competitors, which can lead to internal changes, said Nancy Strassel, vice president of the Greater Cincinnati Health Council.
As hospitals battle for market share, those that cannot show continuing reductions in C-section rates and costs without harming quality may face tough questions from business groups concerned about high medical costs, she said.
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