For-profit hospitals mean more Cesarean births (and that means bigger profits)

Cesarean sections are much more likely to occur in for-profit hospitals than in not for-profit hospitals according to a new study from California Watch.

Skyrocketing C-section rates in the USA are raising concerns about women's health and the medical complications that are associated with C-sections.

Data from  253 hospitals in the state show a big variation in C-section rates. At nonprofit Kaiser Permanente Redwood City Medical Center, the C-section rate was 9 percent. At for-profit Los Angeles Community Hospital, the rate 47 percent. In Riverside County, hospitals just miles apart had dramatically different rates, even though they serve essentially the same population.

Throughout the state, women are 17% more likely to have a C-section in a for-profit hospital.

In California, hospitals can increase their revenue by 82 percent on average by performing a C-section instead of a vaginal birth, according to a 2007 analysis by the Pacific Business Group on Health. The group – a coalition of business, education and government agencies – estimated that average hospital profits on an uncomplicated C-section were $2,240, while profits for a comparable vaginal birth were $1,230.

A spokesman with for-profit hospital chain Tenet Healthcare said California Watch's premise was wrong and that the choice of C-section is made by the patient and doctor without influence by the hospital.  Tenet Healthcare representative Rick Black said “You don’t just come into a hospital and they say, ‘We want to give you a C-section so we can drive up profits.’ ”

To doctors and other health professionals, the results of the California Watch analysis were troubling.  “We take this extremely seriously. The wide variation in C-section rates really is a cause for concern,” said Dr. Jeanne Conry, California district chairwoman of the American Congress of Obstetricians and Gynecologists.

“If you look at this variation among hospitals, it’s clear we can’t just blame women,” said Debra Bingham, president-elect of Lamaze International, a group that promotes natural birth.

California Watch previously reported  that the state’s maternal death rate has increased dramatically (nearly tripling in the past decade), and researchers are exploring the possible connection to the rise in C-sections during the same time period.

For National Public Radio's story, see this.


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