First Lady Tammy Murphy and the Department of Health on Thursday, released the first New Jersey Report Card of Hospital Maternity Care which includes interactive data on hospital-specific and statewide surgical births, complication rates and severe maternal birth complications.
The public Report Card dashboard allows users to select a New Jersey birthing hospital and view the total number of births, methods of delivery and complication rates — postpartum hemorrhage, third- and fourth-degree perineal lacerations, high vaginal lacerations, post-admission infections and severe maternal morbidity.
It enables users to compare rates by hospital and view statewide breakdowns by race. Outcomes by factors such as a mother’s race/ethnicity, age, education level, pre-pregnancy body mass index and health insurance type can also be selected.
“The color of one’s skin should not impact the quality of care received, or one’s chances of delivering safely,” Murphy said in a statement. “By examining data to determine the factors that are contributing to maternal morbidities and poor health outcomes, we are working every angle to better serve our mothers, babies and families.”
The Report Card also includes the rate of Nulliparous Term Singleton and Vertex (NTSV) cesarean births among first-time mothers who carried a single fetus to term (37 or more weeks) in a head-first position. While often medically necessary, a C-section is associated with elevated risks for hemorrhage, infection, complications from anesthesia, future pregnancy complications and infant respiratory problems.
“Women deserve vigilant, reliable and culturally-competent care throughout pregnancy, labor and well after birth. This new dashboard offers hospitals and the public a snapshot of maternal care provided across the state, and an opportunity to examine areas in need of improvement—and you can’t improve these challenging areas without measurable, accurate data,” Health Commissioner Dr. Shereef Elnahal said. “At the Department, we are improving our data systems to drive quality improvement across the health care continuum with the ultimate goal of improving the lives of mothers and their babies.”
After consulting with subject matter experts in the maternal and child health field, the department produced risk-adjusted rates to account for the mix of delivering mothers by sociodemographic and prehospital health characteristics of patients for each hospital. A hospital’s risk-adjusted rate is compared to the statewide rate to determine if the difference between the state rate and the hospital’s risk-adjusted rate is significantly higher or lower.
Severe maternal morbidity is defined as unexpected outcomes of labor and delivery that result in significant short- or long-term health impacts. These include aneurysm, cardiac arrest, sepsis, eclampsia, severe anesthesia complications, blood transfusion and other unexpected outcomes. In 2016, black mothers suffered the highest rate of severe maternal morbidity with 311.8 per 10,000 delivery hospitalizations while the rate for white mothers was 134 per 10,000 delivery hospitalizations.
Through Murphy’s Nurture NJ initiative, the department said that it is committed to sharing high-quality data to drive improvements for mothers and babies. The Report Card — which is based on 2016 data — is designed to inform stakeholders and the public about maternity care provided at each of New Jersey’s 49 birthing hospitals. Its release is part of the Department’s statutory requirement under P.L. 2018, c.82 to publish it annually. This data is part of the Department’s Maternal Data Center that will be updated regularly with resources for the public and providers, and the Department’s latest maternal health data.
The Report Card is intended for individuals to make informed comparisons but should not be used as a lone decision-making tool, the Department said. In determining the best hospital for you, the department strongly suggests discussing specific health care needs with a health care provider.
The department is working to address maternal mortality and morbidity by reducing the state’s high cesarean birth rate with stakeholders including hospital leadership, health care providers and maternal and child health partners. For the first time, the Department last month released surgical/cesarean birth rates by hospital among women considered at low risk for birth complications. The national target for these surgical procedures is 23.9 per 100 live births and New Jersey’s rate was well above that target at 30.3 per 100 live births in 2016. Within their own facilities, only 8 out of 49 New Jersey birthing hospitals meet the benchmark.
Last month, Gov. Phil Murphy signed legislation to establish a Maternal Mortality Review Committee that will annually review and report on rates and causes of maternal mortality in New Jersey and recommend improvements. This committee will work closely with the New Jersey Maternal Care Quality Collaborative, a multidisciplinary team of stakeholders that will oversee the transformation of maternal health care in the state. It will also establish a shared vision and statewide goals for key health services focused on decreasing maternal deaths, injuries as well as racial and ethnic disparities.