Health System Complexity and the Global Cesarean Pandemic with Neel Shah

The optimal cesarean rate is challenging to discern, but as many as half of cesareans performed on Americans may be avoidable. Each year, unnecessary cesareans come at the cost of $5 billion in excess spending: 20,000 major surgical complications, and unmeasured pain and suffering. This suggests a massive systems failure that requires a systems solution.

While there are no easy answers, recent data offers an important clue. There is tremendous variation in cesarean rates by hospital, ranging from 7% to 70%. This means that in 2016 a mother’s greatest risk factor for getting a cesarean may be which hospital she utilizes. Dr. Shah will explain efforts to understand what makes Hospital A different from Hospital B and how this understanding may inform the design of a scalable intervention that measurably improves the care of mothers and babies.