Obstetric Reports

Log into the OBI Registry to See Your Hospital’s Obstetric Reports                                              Data Sources                                                                                                                                Cesarean Delivery Rates                                                                                                   AVAILABLE REPORTS                                                                                                                          - Hospital Summary Report                                                                                                                 - Maternal Outcomes Report                                                                                                               - Maternal Utilization Report                                                                                                     Definitions & References

low risk pic & def.PNG

The Obstetrics Initiative provides Obstetric Reports to support your obstetric quality improvement efforts. 

Want to see your hospital's Obstetric Reports?

log into the OBI registry

The Obstetric Reports provide rich data to understand your hospital’s cesarean delivery and vaginal delivery rates for “low” and “non-low” risk groups of patients [ref], and to assess maternal and fetal outcomes after adjusting for your patient population. These reports can also help hospitals monitor maternal and neonatal outcomes after implementing interventions to improve maternity care quality and support vaginal birth. 

The Obstetric Reports are optimized for peer-to-peer comparison and monitoring trends over time. Our reports provide data-driven insights into areas for focused quality improvement.

Data Sources

The Obstetrics Initiative collates data from Blue Cross Blue Shield of Michigan (BCBSM) preferred provider organization (PPO) and Blue Care Network (BCN) claims. OBI has BCBSM claims data for 66 Michigan maternity hospitals.

OBI is currently working to create reports with birth certificate data from the Michigan Department of Health and Human Services Vital Statistics (MDHHS)  and discharge data from the Michigan Hospital Association.  This will provide data on births covered by all payers (including Medicaid) from the 82 Michigan maternity hospitals. The first report will be the NTSV report, hospitals will be notified once it is available.

Cesarean Delivery rates

Nulliparous Term Singleton Vertex (NTSV) Cesarean Delivery Rate: Using birth certificate data from the Michigan Department of Health & Human Services, the NTSV Cesarean Delivery rate is the percentage of nulliparous women who have a Cesarean Delivery and who are term (>=37 weeks gestation) with a singleton, vertex gestation. 

Society for Maternal Fetal Medicine (SMFM) Cesarean Delivery Rate: Using claims data for the Preferred Provider Organization (PPO) patients in Blue Cross Blue Shield (BCBS), the SMFM Cesarean Delivery rate is the percentage of women who have a Cesarean Delivery and who are term (>=37 weeks) with a singleton, vertex, live born gestation and without a relative or absolute contraindications to vaginal delivery.

AVAILABLE REPORTS

Obstetrics Hospital Summary Report 

The Obstetrics Hospital Summary Report benchmarks your hospitals performance, against other Michigan hospitals for the following outcomes with Blue Cross Blue Shield of Michigan claims data.

  • Vaginal and cesarean birth rates among low risk and non-low risk singleton births

  • Vaginal birth after cesarean (VBAC) rates

  • Standardized facility, professional, post discharge care payments

  • Analysis of the proportion of patients considered “non-low risk” deliveries

Need help navigating the report and running queries? Check out our report navigation guide

The registry report does not provide a further breakdown of the outpatient facility-based rate to determine categories unless you drill down and filter to view those details for BCBSM patients. You could do this by going to the Episode Cost Table ($), filtering for OBGYN (and applying any other filters you would need) and then drilling down into the episode list via the hyperlink in the drop down legend. After this, you would perform an advanced export for the data to include all of the different outpatient facility-based categories. Here is a step-by-step walk you through of the export process.

Maternal Outcomes Report

Maternal Outcomes Report shows the maternal outcomes against other Michigan hospitals with Blue Cross Blue Shield of Michigan claims data. This report is important because as we work to safely reduce the use of primary cesarean delivery, we have to carefully monitor maternal and neonatal outcomes. This report was developed with these Severe Maternal Morbidity (SMM) Definitions: ICD-9 & ICD-10 codes. We are currently working on the  Neonatal Outcomes Report.

The Reports has four sections:

  1. Severe Maternal Morbidity (SMM), Overall

    • Any severe maternal morbidity (SMM)

    • Bleeding

    • Cardiovascular

    • Non-cardiovascular

  2. Severe Maternal Morbidity, Cardiovascular

    • Acute MI/ Cardiac Arrest/ Ventricular Fibrillation

    • Heart Failure / Pulmonary Edema

    • Eclampsia

    • Puerperal Cerebrovascular Accident (CVA)

  3. Severe Maternal Morbidity (SMM), Non-Cardiovascular

    • Sepsis

    • Acute Renal Failure (SMM)

    • Acute respiratory distress syndrome (ARDS) (SMM)

    • Severe Anesthesia Complications (SMM)

    • Embolism

  4. Obstetric Morbidity (not SMM)

    • Uterine Rupture

    • Uterine Inversion

    • Maternal Pyrexia

    • Puerperal Infection

    • Non Puerperal Infection

Maternal Utilization Report

The Maternal Utilization Reports shows the maternal utilization against other Michigan hospitals with Blue Cross Blue Shield of Michigan claims data. This report was developed with these Severe Maternal Morbidity (SMM) Definitions: ICD-9 & ICD-10 codes.

This report also has four sections:

  1. Procedures

    • Blood Transfusion (from SMM)

    • Hysterectomy (from SMM)

    • Uterine Artery Embolization

  2. Hospital Utilization

    • Emergency Department Visits

    • Readmission

    • Length of Stay (LOS) >2 days

    • Length of Stay (LOS) >4 days

  3. Cardiopulmonary (SMM)

    • Cardioversion of Cardiac

    • Arrhythmia

    • Tracheostomy

    • Ventilation

  4. Payment

    • Total

    • Index Facility

    • Professional

    • Readmit

    • Post-discharge

COMING SOON:

  • Nulliparous, Term, Singleton, Vertex (NTSV) Cesarean Birth Rate Report - December 2018

  • Infant Outcomes Report - Spring 2019

  • Infant Utilization Report- Spring 2019

definitions & References

Low-Risk vs. Non-Low Risk Definitions: ICD-9 & ICD-10 codes

Low-Risk for Claims Data: Comparing variation in hospital rates of cesarean delivery among low-risk women using 3 different measures. Armstrong, Joanne C. et al. American Journal of Obstetrics & Gynecology, February 2016, 214:2, Pages 153–163.

Severe Maternal Morbidity (SMM) Definitions: ICD-9 & ICD-10 codes

 Nulliparous, Term, Singleton, Vertex (NTSV)

Nulliparous, Term, Singleton, Vertex (NTSV)

Low-risk rates in MI & US.PNG
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