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The California Hospital Outcomes Project is an initiative mandated by the State of California and conducted by the Office of Statewide Health Planning and Development (OSHPD), to develop public reports comparing hospital outcomes for selected medical conditions and surgical procedures for patients treated in hospitals throughout California. Over the last decade, CHOP has reported risk-adjusted hospital mortality rates for heart attack and community-acquired pneumonia. In 2005, OSHPD is releasing its first report on obstetric care.Delivery was selected as an important topic for public reporting because it is the most frequent single reason for hospitalization in California, and because complications of delivery are associated with substantial health care costs and impairment of function. In 2003, for example, there were 170,465 repairs of obstetric lacerations and 147,084 cesarean deliveries performed in California hospitals – more than any other surgical procedure. Although most women who require these procedures have excellent outcomes, a small minority experience complications that cause pain, weakness, impaired bonding with their new child, bowel or bladder problems, sexual dysfunction, rehospitalization, and even death.This technical report, prepared for OSHPD, summarizes the validation of multiple potential measures of inpatient obstetric quality of care. These measures include two that have been endorsed by OSHPD for public reporting: risk-adjusted postpartum maternal readmission rates and risk-adjusted perineal laceration rates. Other measures were also evaluated in this validation study, but are not recommended for public reporting, including risk-adjusted rates of endometritis, wound infection, hemorrhage, and urinary tract infection. This validation study was designed by the UC Davis research team in collaboration with OSHPD staff and the AB 524 Technical Advisory Committee. It was designed to address a variety of concerns, specified in detail later in thi

The California Hospital Outcomes Project is an initiative mandated by the State of California and conducted by the Office of Statewide Health Planning and Development (OSHPD), to develop public reports comparing hospital outcomes for selected medical conditions and surgical procedures for patients treated in hospitals throughout California. Over the last decade, CHOP has reported risk-adjusted hospital mortality rates for heart attack and community-acquired pneumonia. In 2005, OSHPD is releasing its first report on obstetric care.Delivery was selected as an important topic for public reporting because it is the most frequent single reason for hospitalization in California, and because complications of delivery are associated with substantial health care costs and impairment of function. In 2003, for example, there were 170,465 repairs of obstetric lacerations and 147,084 cesarean deliveries performed in California hospitals – more than any other surgical procedure. Although most women who require these procedures have excellent outcomes, a small minority experience complications that cause pain, weakness, impaired bonding with their new child, bowel or bladder problems, sexual dysfunction, rehospitalization, and even death.This technical report, prepared for OSHPD, summarizes the validation of multiple potential measures of inpatient obstetric quality of care. These measures include two that have been endorsed by OSHPD for public reporting: risk-adjusted postpartum maternal readmission rates and risk-adjusted perineal laceration rates. Other measures were also evaluated in this validation study, but are not recommended for public reporting, including risk-adjusted rates of endometritis, wound infection, hemorrhage, and urinary tract infection. This validation study was designed by the UC Davis research team in collaboration with OSHPD staff and the AB 524 Technical Advisory Committee. It was designed to address a variety of concerns, specified in detail later in thi