As an expert in the field of obstetrics and gynecology, I have witnessed firsthand the dramatic increase in the number of Caesarean sections (CS) being performed worldwide. In fact, CS is now the most frequently performed major operation globally, with over 1 million procedures being carried out each year in the United States alone. This is a significant increase from previous generations and begs the question: why are C-section rates skyrocketing?The answer is not a simple one, but there are several factors that contribute to this trend. One of the most important variables is the hospital where a woman chooses to deliver her baby.
It may come as a surprise, but the hospital itself can greatly influence a woman's chances of having a C-section. This is something that I, along with many other health leaders, believe needs to be addressed.Dr. Neel Shah, an adjunct professor at Harvard Medical School and associate professor at Ariadne Labs for Health Systems Innovation, has made it his mission to improve delivery rates with low intervention. He is also the founder of Costs of Care, a global NGO that provides information to doctors in order to provide better care at a lower cost.
Dr. Shah has been recognized as one of the 40 smartest people in healthcare by Becker's Hospital Review. I had the opportunity to speak with Dr. Shah about his work and his efforts to reduce healthcare costs. As he explained, C-sections are not only the most common major surgery performed on human beings worldwide, but they are also the most common in the United States.
In fact, they have become 500 percent more common in just one generation of mothers. This is a staggering statistic and one that we still do not fully understand. One of the most concerning aspects of this trend is the incredible variation in C-section rates from one hospital to another. In the US, rates can range from 7 to 70 percent of births, indicating that the biggest risk factor for a woman to undergo a C-section may be the hospital she chooses, rather than her own risk or preference. This is a significant issue that needs to be addressed. Looking at the way hospitals are managed, it is not surprising that C-section rates are so high.
In the US, 99 percent of babies are born on delivery floors. This is because unlike other parts of the hospital, the delivery unit operates in an environment of constant uncertainty. They do not know how many patients will arrive or how long it will take for them to give birth. Labor can be short or long, and there is no way to predict which patients will need acute surgery.
This creates a challenging situation for managers who must make quick decisions and learn on the go. At Costs of Care, we have developed educational modules to help doctors improve their skills and provide better care for their patients. We have found that many doctors are not aware of the true costs associated with healthcare. In fact, if you show a generic US medical bill to a doctor, they will likely find several things that are not right. This is because prices are often inflated and determined arbitrarily, leading doctors to order unnecessary tests and procedures. However, it is important to recognize that doctors are not solely responsible for rising healthcare costs.
As Dr. Shah explained, leaders must demonstrate to doctors that thinking about costs does not mean skimping on necessary care. Instead, attention should be focused on areas where costs increase without improving patient outcomes. This is something that doctors must take ownership of and work towards improving. Of course, there are other factors at play as well.
Patients may demand certain treatments or express concerns about medical malpractice, and these concerns must be addressed. However, it is important to recognize that these are not the only reasons for rising healthcare costs. As a country, we still have a lot of work to do in order to make healthcare more affordable for all Americans. While there have been some improvements, such as making it easier for individuals to purchase insurance, there is still much progress to be made. As an expert in this field, I have seen firsthand the benefits of these changes.
For example, being a woman is no longer considered a pre-existing condition when it comes to insurance coverage. This is a great form of social progress, but it is not a complete solution. As we continue to work towards improving healthcare and reducing costs, it is important to recognize the impact that hospitals and doctors have on C-section rates. By addressing these issues and working towards better care at a lower cost, we can make significant strides in improving the health and well-being of mothers and babies around the world.
