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The most common reasons for hospital stays: being pregnant, giving birth & being born.

 

The most recent data published by Agency on Healthcare Research and Quality show that stays that involved pregnancy, childbirth, and being born are by far the most common reasons for hospitalization in the United States.

 
 
 

Though the pregnancy, birth and postpartum period is usually a safe window of time in a person's life, evidence shows us that the United States is spending more than any other industrialized nation on health care, but these expenditures do not always translate into healthy outcomes. In addition to having the highest maternal death rate of developed nations, the United States' rate of deaths from pregnancy-related complications is rising, while all other developed nations' rates have dropped. Certain populations experience poor outcomes at a higher rate than others.

A Wall Street Journal analysis of CDC data from 2015 showed that women in rural areas die of pregnancy-related complications at a 64% higher rate than those in large U.S. cities, whereas women fared better in rural hospitals in 2000. African-American mothers and babies in any location, rural or urban, are 3- to 4- times more likely than their white counterparts to die.

Our organization identified three challenges that need attention.

 

 
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Challenge 1.

Rural Health Disparities

There is a shortage of maternity care providers in rural areas and needs for more support, training, and infrastructure. Since 2010, 82 rural hospitals have closed nationwide and up to 700 more are at risk of closing within the next 10 years according to the National Rural Health Association. Maternity services generally do not improve a small hospital's financial bottom line and rural clinicians are hard to recruit and retain. 

 

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Challenge 2.

Measurement Gaps

"Measures that matter" has been the philosophical tagline of major patient safety and quality measurement organizations in recent years. As data collection and availability have improved in the last decade along with a push for value-based reimbursement, there remains an opportunity for hospitals and health systems to improve both data collection and transparency. Data deserts leave pregnant women, policy makers and the public in the dark.

 

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Challenge 3.

Solution Silos

Several women's health organizations and grantors have invested in building toolkits for improvement, regional data collection services and supporting community programs. Federal and state grant funding exists, but a recent ProPublica/NPR investigation found that only 6 percent of block grants for "maternal and child health" actually go to the health of mothers. The rate of change is slow and the process is fragmented. High-impact maternal health solutions require all hands on deck for marketing, funding, implementation and subsequent data collection.

 

 


SOURCES:

McDermott KW (IBM Watson Health), Freeman WJ (AHRQ), Elixhauser A (AHRQ). Overview of Operating Room Procedures During Inpatient Stays in U.S. Hospitals, 2014. HCUP Statistical Brief #233. December 2017. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/statbriefs/sb233-Operating-Room-Procedures-United-States-2014.pdf

McDermott KW (IBM Watson Health), Elixhauser A (AHRQ), Sun R (AHRQ). Trends in Hospital Inpatient Stays in the United States, 2005-2014. HCUP Statistical Brief #225. June 2017. Agency for Healthcare Research and Quality, Rockville, MD. www.hcup-us.ahrq.gov/reports/statbriefs/sb225-Inpatient-US-Stays-Trends.pdf