By John Ballard
Via Peter Daou
For-profit hospitals across [California] are performing cesarean sections at higher rates than nonprofit hospitals, a California Watch analysis has found.
A database compiled from state birthing records revealed that women were at least 17 percent more likely to have a cesarean section at a for-profit hospital than at a nonprofit or public hospital from 2005 to 2007. A surgical birth can bring in twice the revenue of a vaginal delivery.
In addition, some hospitals appear to be performing more C-sections for nonmedical reasons -- including an individual doctor's level of patience and the staffing schedules in maternity wards, according to interviews with health professionals.***
Medical experts have been unable to pinpoint exactly why some hospitals perform far more C-sections, or "operative deliveries," than other medical facilities.
Yet one important factor has always loomed over the debate about the rise in C-sections: the bottom line. In California, hospitals can increase their revenues by 82 percent on average by performing a C-section instead of a vaginal birth, according to a 2007 analysis by the Pacific Business Group on Health.
The group -- a coalition of business, education and government agencies -- estimated that average hospital profits on an uncomplicated C-section were $2,240, and profits for a comparable vaginal birth were $1,230.
California Watch examined the births least likely to require C-sections, those in which mothers without prior C-sections carry a single fetus -- positioned head down -- at full term, and found that, after adjusting for the age of the mothers, the average weighted C-section rate for nonprofit hospitals was 16 percent, and for-profit hospitals had a rate of 19 percent.
That may seem like a small percentage gap to the casual observer, but medical experts consider it significant. It means women are 17 percent more likely to have a C-section if they give birth at a for-profit hospital.
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