C-sections

From HMCwiki

The rate of elective Cesarean sections, commonly referred to as C-sections, has reached an all time high, increasing forty percent since 1996. When the term elective proceeds the word C-section, it is meant to infer that the C-section was not performed out of medical necessity. Rather, personal preference, which can include convenience, scheduling care for other children and/or fear of vaginal delivery dictated that the C-section was elected as the primary choice of delivery.

The Healthcare Management Council compared the cost per case of DRG 371: Cesarean Section without Complication in 15 hospitals of varying size across the United States. This analysis revealed that, on average, the overall cost per case for C-sections without complications increased approximately 5% across the comparison group. While this analysis did not differentiate between elective C-sections and non-elective C-sections, at a time when healthcare is facing a significant squeeze on financial resources, increasing costs on a procedure with rapidly increasing volumes is problematic. Decreasing C-section rates is an issue that Clinical Service Line leaders, Physicians and RN Managers alike should focus their efforts upon.

C-section practice differentiation

Organizing the C-section team is an important part of improving the process flow of C-section patients. Who performs C-sections (Labor and Delivery (L&D) staff or Operating Room (OR) staff) and on what unit those C-sections are peformed are two of the primary drivers of cost variation.

Importance of care path guidelines

Physicians sometimes elect to perform C-sections when labor does not seem to be progressing. However, without a clear guideline for defining labor, physicians can rush into performing a C-section too early into the delivery process. Developing and institution guidelines for administering medications that aid in uterine contractions are also helpful in managing C-section rates.

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