VBAC & Cesarean Rates of California Hospitals, 2006

I’ve copy and pasted the entire spreadsheet below.  Be sure to read, “Why if your hospital ‘allows’ VBAC isn’t enough.”

If you look at the PDF (link provided below), you will see that the California Office of Statewide Health Planning and Development has cesarean section and primary cesarean section listed as “POSSIBLE OVER UTILIZATION” and VBAC listed as “POSSIBLE UNDER UTILIZATION.”  Interesting.  They further address the high cesarean and low VBAC rates in this press release, dated January 17, 2008, which states:

• The hospital level data will help consumers and payers make more informed healthcare choices by providing information on the experience hospitals have in performing specific procedures and on the rates of use for various procedures.
• “One alarming trend we see in the 2006 data is the increased use of Caesarean Sections,” said OSHPD Director Dr. David Carlisle. “We are seeing rates that exceed 50% at some hospitals, which is very concerning because the operation is not always necessary, has known complications, and ultimately drives up healthcare costs.”
• The 2006 data on maternal care suggests that some healthcare providers are more likely to perform cesarean section deliveries than others, with rates varying between 50% and 14% depending on the hospital.
• Data has shown that many cesarean deliveries are inappropriate and lead to significant complications for the mother.
• While there are no standards for cesarean rates, this data will help consumers compare birth delivery data to make more informed choices about their health. This is particularly true for maternal care in which mothers and their families often have the opportunity to make plans about the type of care they wish to receive.
• OSHPD reports 5 utilization indicators for procedures where evidence shows there is under use or overuse, along with large variation in rates across hospitals. Each of the four maternal indicators is risk- adjusted for age, and the laparoscopic cholecystectomy indicator is adjusted for both age and sex. The indicators include:
  • Cesarean Delivery Rate (2): Number of Cesarean Section Deliveries per 100 Deliveries (excludes abnormal presentation, preterm, fetal death, multiple gestation, and breech procedures). Cesarean delivery may be overused in some facilities, so lower rates may represent better care.
  • Vaginal Birth After Cesarean (VBAC) Rate: Number of vaginal births per 100 women with a previous Cesarean delivery. VBAC may be underused in some facilities, so higher rates may represent better care, though this rate includes some women who were probably not good candidates for vaginal birth.

Top 5 California Hospitals: VBACs Performed

1. Santa Clara Valley Medical Center – 265
2. Alta Bates Summit Medical Center – Alta Bates Campus – 216
3. California Hospital Medical Center – Los Angeles – 158
4. Kern Medical Center- 132
5. St. Francis Medical Center – 130

Top 5 California Hospitals: VBAC Rate

1. Kaiser Fnd Hosp – Redwood City – 34.5% (50 VBACs)
2. Santa Clara Valley Medical Center – 32.0% (265 VBACs)
3. Alameda Co Medical Center – Highland Campus – 31.3% (77 VBACs)
4. Kaiser Fnd Hosp – South Sacramento – 30.6% (125 VBACs)
5. Seton Medical Center – 30.3% (21 VBACs)

Top 5 Hospitals: Primary Cesareans Performed

1. Sharp Mary Birch Hospital For Women – 1,261 (20.7%)
2. Cedars Sinai Medical Center – 1,153 (19.8%)
3. Citrus Valley Medical Center – Qv Campus – 1,136 (28.7%)
4. Pomona Valley Hospital Medical Center – 1,057 (18.7%)
5. St. Francis Medical Center – 953 (19.4%)

Top 5 Hospitals: Overall Cesareans Performed

1. Pomona Valley Hospital Medical Center – 2,252
2. Sharp Mary Birch Hospital For Women – 2,221
3. Citrus Valley Medical Center – Qv Campus – 2,105
4. St. Francis Medical Center – 1,837
5. Community Regional Medical Center-Fresno – 1,804

Top 6 Hospitals: Overall Cesarean Rate

1. Sharp Memorial Hospital – 77.9% (3 CS)
2. Los Angeles Community Hospital- 54.6% (232 CS)
3. East Valley Hospital Medical Center – 53.2% (195 CS)
4. Community And Mission Hsp Of Hntg Park – Slauson – 50.9% (889 CS)
5. East Los Angeles Doctors Hospital – 44.6% (368 CS)
6. Pacifica Hospital Of The Valley – 43.7% (435 CS)

Inland Empire Hospitals – VBAC vs. Primary CS Rates

1. Loma Linda University Medical Center, 18.9% vs. 13.1%
2. Kaiser Fnd Hosp – Fontana, 15.2% vs 13.9%
3. St. Bernardine Medical Center, 5.8% vs 10.5%
4. Pomona Valley Hospital Medical Center, 3.8% vs 18.7%
5. St. Mary Regional Medical Center, 2.5% vs 8.6%
6. Parkview Community Hospital Medical Center, 1.7% vs 18.4%
7. Riverside Community Hospital, 1.3% vs 17.7%
8. Community Hospital Of San Bernardino, 1.0% vs. 23.2%
9. San Antonio Community Hospital, 0.9% vs 24.1%
10. Corona Regional Medical Center – Main, 0.8% vs. 16.4%
11. Montclair Hospital Medical Center – 0.5% vs 21.3%
12. Hemet Valley Medical Center, 0.5% vs 29.2%
13. Redlands Community Hospital – 0% vs 15.2%
14. Hi-Desert Medical Center – 0% vs. 19.5%
15. Chino Valley Medical Center – 0% vs 12%
16. Eisenhower Memorial Hospital, No births reported

Hospitals with VBAC Bans?

All these hospitals had 5 or fewer VBACs in 2006.  I wonder if it is because they have banned them.  There are 259 hospitals that reported births and the 101 listed below represents 39% of them.  I guess they should read this and this.

1. Anaheim General Hospital
2. Banner Lassen Medical Center
3. Barstow Community Hospital
4. Barton Memorial Hospital
5. Bellflower Medical Center
6. Beverly Hospital
7. Centinela Freeman Reg Medical Center – Memorial Campus
8. Central Valley General Hospital
9. Chino Valley Medical Center
10. Coastal Communities Hospital
11. Colusa Regional Medical Center
12. Community Hospital Monterey Peninsula
13. Community Hospital Of San Bernardino
14. Corona Regional Medical Center – Main
15. Delano Regional Medical Center
16. Desert Valley Hospital
17. Doctors Hospital Of Manteca
18. Doctors Medical Center – San Pablo Campus
19. East Los Angeles Doctors Hospital
20. East Valley Hospital Medical Center
21. Eden Medical Center
22. El Centro Regional Medical Center
23. Fairchild Medical Center
24. Feather River Hospital
25. Foothill Presbyterian Hospital-Johnston Memorial
26. French Hospital Medical Center
27. George L Mee Memorial Hospital
28. Goleta Valley Cottage Hospital
29. Greater El Monte Community Hospital
30. Hazel Hawkins Memorial Hospital
31. Hemet Valley Medical Center
32. Henry Mayo Newhall Memorial Hospital
33. Hi-Desert Medical Center
34. La Palma Intercommunity Hospital
35. Little Company Of Mary – San Pedro Hospital
36. Lodi Memorial Hospital
37. Lompoc Healthcare District
38. Los Angeles Community Hospital
39. Los Angeles Metropolitan Medical Center
40. Mammoth Hospital
41. Marian Medical Center
42. Mark Twain St. Joseph’S Hospital
43. Mayers Memorial Hospital
44. Memorial Hospital Los Banos
45. Memorial Hospital Medical Center – Modesto
46. Memorial Hospital Of Gardena
47. Mendocino Coast District Hospital
48. Mercy Medical Center Mt. Shasta
49. Montclair Hospital Medical Center
50. Monterey Park Hospital
51. Moreno Valley Community Hospital
52. Mountains Community Hospital
53. Natividad Medical Center
54. Northern Inyo Hospital
55. Oak Valley District Hospital (2-Rh)
56. Oroville Hospital
57. Pacific Alliance Medical Center, Inc.
58. Pacific Hospital Of Long Beach
59. Palo Verde Hospital
60. Paradise Valley Hospital
61. Parkview Community Hospital Medical Center
62. Petaluma Valley Hospital
63. Pioneers Memorial Hospital
64. Plumas District Hospital
65. Pomerado Hospital
66. Providence Holy Cross Medical Center
67. Redbud Community Hospital
68. Redlands Community Hospital
69. Regional Medical Of San Jose
70. Ridgecrest Regional Hospital
71. Salinas Valley Memorial Hospital
72. San Antonio Community Hospital
73. San Dimas Community Hospital
74. San Gorgonio Memorial Hospital
75. San Ramon Regional Medical Center
76. Santa Barbara Cottage Hospital
77. Sierra Kings District Hospital
78. Sierra Nevada Memorial Hospital
79. Sierra View District Hospital
80. Simi Valley Hospital And Health Care Svcs-Sycamore
81. Sonoma Valley Hospital
82. Sonora Regional Medical Center – Greenley
83. St. Elizabeth Community Hospital
84. St. Helena Hospital
85. St. John’S Pleasant Valley Hospital
86. St. John’S Regional Medical Center
87. St. Joseph Hospital – Eureka
88. St. Louise Regional Hospital
89. St. Rose Hospital
90. Sutter Amador Hospital
91. Sutter Auburn Faith Hospital
92. Sutter Coast Hospital
93. Sutter Davis Hospital
94. Sutter Lakeside Hospital
95. Sutter Medical Center Of Santa Rosa
96. Sutter Tracy Community Hospital
97. Twin Cities Community Hospital
98. Verdugo Hills Hospital
99. Victor Valley Community Hospital
100. Western Medical Center Hospital – Anaheim
101. Woodland Memorial Hospital

Utilization Rates* for Selected Medical Procedures in California Hospitals, 2006
Office of Statewide Health Planning and Development, Hospital Patient Data**  (Here is the info as a Adobe Acrobat PDF for easy printing and as an Excel file if you want to sort the numbers yourself.)