OHCA Cesarean Section Quality Initiative

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.

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 has initiated an ongoing quality initiative.

Goal:

 Reduction of Primary Cesarean Sections Without Medical Indication.

Methodology:  

• Beginning in January 2011 and continuing over the subsequent 8 months through August 2011, every contracted OHCA in-state provider & hospital that performed a minimum of 2 SoonerCare deliveries per a month received a letter with their primary C-section rate and total C-section rate every month. After August, 2011, rates have been reported quarterly. The rates are 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