Over the last two decades, the Cesarean section (C-section) rate has continued to steadily and consistently increase without a corresponding improvement in maternal or neonatal outcomes. Professional sources report a range from 3% – 30% for operative deliveries performed without medical indication.
SoonerCare Rates
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SFY 1996
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SFY 2007
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SFY 2009
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Total C-Section Rate
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22.5%
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33.6%
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32.16%
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Primary C-Section Rate
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20.3%
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SFY 2011 Results
The Oklahoma Health Care Authority (OHCA) shares this concern for our members. In an attempt to lower the primary C-section rate performed without medical indication, OHCA will initiate a multifaceted, ongoing quality initiative. Based on review of sources, OHCA has set a goal over the first year of the program.
Goal: Reduction of Primary Cesarean Sections Without Medical Indication
Phase I – Data collection, feedback to providers and education.
(Began data pulling - January 2011)
Phase II – Medical chart review. (Beginning - September 2011)
Methodology:
- Beginning in January 2011 and continuing over the subsequent 8 months through August 2011, every contracted OHCA in-state provider & hospital that performs a minimum of 2 SoonerCare deliveries per a month will receive a letter with their primary C-section rate and total C-section rate every month. Providers & hospitals will receive subsequential letters thereafter. After August, 2011, rates will be reported quarterly. The rates will be computed as follows:
- Primary C/S rate = Primary c-sections divided by the sum of primary c-sections + vaginal deliveries
- Total C/S rate = All c-sections divided by all deliveries
- Exclusions = Assistant surgeons and VBACs
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Details of the initiative have been mailed to both obstetrical providers and hospitals. If you have questions or comments please submit to CSectionFeedback@okhca.org or call Beverly Rupert, RN, BS at 405-522-7239
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