Cost of low-risk childbirth varies widely among hospitals

Childbirth is the leading cause of hospital admission in the United States, but there has been little research on the cost of delivery in hospitals across the country. To seek some answers, the Yale research team, led by Xiao Xu, assistant professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine, studied data from the 2011 Nationwide Inpatient Sample of 463 hospitals across the country. The team found that there is a large variation in the average estimated hospital facility cost per maternity stay.

"The average estimated facility cost per maternity stay ranged from $1,189 to $11,986 with a 2.2-fold difference between the 10th and 90th percentile," said Xu. "Our results could inform discussions on potential cost-saving opportunities."

Xu and her team also found that hospitals with higher rates of cesarean delivery or serious maternal complications had significantly higher costs. However, adjustments for conventional hospital characteristics, such as teaching status, urban/rural location, volume of births, and the cesarean section rates, only explained a small proportion of the wide variation in estimated hospital facility costs for low-risk childbirths.

"Hospital practices might be an important contributor to the variation in costs, and there may be opportunities for cost reduction," said Xu. "These may include safely reducing cesarean deliveries, increasing the coordination of care, and emphasizing the value of care through new payment and delivery systems.