From: Identifying individual hospital levels of maternal care using administrative data
Variable | Non-Obstetric N = 10,859 (0.2%) | Level I N = 467,368 (6.8%) | Level II N = 2,861,713 (41.5%) | Level III N = 2,442,605 (35.4%) | Level IV N = 1,113,055 (16.1%) | P-value |
---|---|---|---|---|---|---|
State | < 0.001 | |||||
CA | 4141 (0.1%) | 178,951 (3.6%) | 2,079,001 (41.8%) | 2,055,616 (41.3%) | 661,168 (13.3%) | |
MO | 4484 (0.6%) | 87,528 (12.1%) | 268,344 (37.0%) | 106,355 (14.7%) | 257,647 (35.6%) | |
PA | 2234 (0.2%) | 200,889 (16.9%) | 514,368 (43.1%) | 280,634 (23.5%) | 194,240 (16.3%) | |
Deliveries/year (median, IQR) | 74 (59–87) | 443 (298–570) | 1562 (1099–2091) | 3318 (2648–4041) | 4511 (3035–6644) | < 0.001 |
Maternal characteristics, N (%) (unless otherwise noted) | ||||||
Maternal age (years; median, IQR) | 25 (21–30) | 26 (22–31) | 27 (23–32) | 28 (24–33) | 28 (23–33) | < 0.001 |
Race | < 0.001 | |||||
White, Non-Hispanic | 8943 (82.4%) | 332,532 (71.2%) | 1,306,403 (45.7%) | 935,697 (38.3%) | 492,285 (44.2%) | |
Black, Non-Hispanic | 289 (2.7%) | 20,293 (4.3%) | 182,813 (6.4%) | 170,257 (7.0%) | 158,016 (14.2%) | |
Hispanic | 1025 (9.4%) | 85,636 (18.3%) | 1,062,409 (37.1%) | 975,757 (40.0%) | 315,668 (28.4%) | |
Asian/Pacific Islander | 195 (1.8%) | 13,680 (2.9%) | 249,544 (8.7%) | 312,415 (12.8%) | 118,043 (10.6%) | |
Other | 407 (3.8%) | 15,227 (3.3%) | 60,544 (2.1%) | 48,479 (2.0%) | 29,043 (2.6%) | |
Insurance | < 0.001 | |||||
FFS | 2184 (20.1%) | 75,691 (16.2%) | 188,818 (6.6%) | 120,363 (4.9%) | 56,676 (5.1%) | |
HMO | 1690 (15.6%) | 134,753 (28.8%) | 1,298,549 (45.4%) | 1,270,782 (52.0%) | 527,953 (47.4%) | |
Public | 5864 (54.0%) | 227,233 (48.6%) | 1,264,669 (44.2%) | 981,462 (40.2%) | 493,018 (44.3%) | |
Other | 1121 (10.3%) | 29,691 (6.4%) | 109,677 (3.8%) | 69,998 (2.9%) | 35,408 (3.2%) | |
Education | < 0.001 | |||||
No High School | 520 (4.8%) | 30,481 (6.5%) | 256,725 (9.0%) | 197,890 (8.1%) | 69,522 (6.3%) | |
Some High School | 2217 (20.4%) | 82,707 (17.7%) | 490,139 (17.1%) | 393,694 (16.1%) | 172,056 (15.5%) | |
High School Diploma/GED | 4364 (40.2%) | 162,316 (34.7%) | 812,643 (28.4%) | 608,347 (24.9%) | 276,107 (24.8%) | |
At least Some College | 3636 (33.5%) | 186,899 (40.0%) | 1,260,098 (44.0%) | 1,180,600 (48.3%) | 563,492 (50.6%) | |
Missing | 122 (1.1%) | 4965 (1.1%) | 42,108 (1.5%) | 62,074 (2.5%) | 31,878 (2.9%) | |
Maternal comorbid and pregnancy associated conditions, N (%) | ||||||
Chronic hypertension | 66 (0.6%) | 3100 (0.7%) | 19,924 (0.7%) | 21,238 (0.9%) | 15,717 (1.4%) | < 0.001 |
PIH | 356 (3.3%) | 12,369 (2.7%) | 79,791 (2.8%) | 83,689 (3.4%) | 58,081 (5.2%) | < 0.001 |
Severe PIH/Eclampsia | 71 (0.7%) | 2369 (0.5%) | 22,327 (0.8%) | 27,832 (1.1%) | 19,506 (1.8%) | < 0.001 |
Gestational diabetes | 359 (3.3%) | 17,911 (3.8%) | 138,214 (4.8%) | 145,951 (6.0%) | 70,231 (6.3%) | < 0.001 |
Diabetes mellitus | 35 (0.3%) | 2236 (0.5%) | 17,287 (0.6%) | 20,877 (0.9%) | 13,156 (1.2%) | < 0.001 |
Renal disease | 27 (0.3%) | 723 (0.2%) | 3514 (0.1%) | 3006 (0.1%) | 2251 (0.2%) | < 0.001 |
Dialysis | 0 (0.0%) | 5 (0.0%) | 99 (0.0%) | 149 (0.01%) | 134 (0.01%) | < 0.001 |
Organ transplant | 0 (0.0%) | 21 (0.0%) | 140 (0.0%) | 253 (0.01%) | 368 (0.03%) | < 0.001 |
Severe chronic conditiona | 2 (0.02%) | 61 (0.01%) | 660 (0.02%) | 954 (0.04%) | 1085 (0.1%) | < 0.001 |
Severe cardiac conditionb | 9 (0.1%) | 376 (0.08%) | 2856 (0.1%) | 3515 (0.1%) | 3346 (0.3%) | < 0.001 |
Placenta previa | 47 (0.4%) | 1537 (0.3%) | 14,011 (0.5%) | 16,393 (0.7%) | 7767 (0.7%) | < 0.001 |
Placenta previa after CS | 10 (0.1%) | 286 (0.1%) | 2859 (0.1%) | 3935 (0.2%) | 1933 (0.2%) | < 0.001 |
Multiple gestation | 132 (1.2%) | 5704 (1.2%) | 61,439 (2.2%) | 78,841 (3.2%) | 43,408 (3.9%) | < 0.001 |
High-risk patientsc | 982 (9.0%) | 41,527 (8.9%) | 311,689 (10.9%) | 337,059 (13.8%) | 188,125 (16.9%) | < 0.001 |
Cesarean section | 3150 (29.0%) | 126,928 (27.2%) | 819,661 (28.6%) | 757,811 (31.0%) | 340,778 (30.6%) | < 0.001 |
Neonatal characteristics, N (%) (unless otherwise noted) | ||||||
Male | 5534 (51.0%) | 238,891 (51.1%) | 1,463,488 (51.1%) | 1,252,240 (51.3%) | 570,285 (51.2%) | < 0.001 |
Birthweight | 3317 (3000,3629) | 3374 (3061,3686) | 3371 (3041,3685) | 3345 (3005,3660) | 3319 (2965,3657) | < 0.001 |
GA, weeks | 39 (38,40) | 39 (38,40) | 39 (38,40) | 39 (38,40.) | 39 (38,40) | < 0.001 |
GA categories, weeks | < 0.001 | |||||
GA < 28 weeks | 42 (0.4%) | 799 (0.2%) | 8510 (0.3%) | 13,045 (0.5%) | 9632 (0.9%) | |
GA 28–31 weeks | 79 (0.7%) | 1682 (0.4%) | 19,247 (0.7%) | 29,233 (1.2%) | 19,549 (1.8%) | |
GA 32–36 weeks | 767 (7.1%) | 29,030 (6.2%) | 229,616 (8.0%) | 236,880 (9.7%) | 122,070 (11.0%) | |
GA 37–41 weeks | 9607 (88.5%) | 420,510 (90.0%) | 2,473,357 (86.4%) | 2,046,481 (83.8%) | 921,954 (82.8%) | |
GA > 41 | 364 (3.4%) | 15,347 (3.3%) | 130,983 (4.6%) | 116,966 (4.8%) | 39,850 (3.6%) |