Wide Variation in Cesarian Rates Indicates Pervasive Quackery

The rate of Cesarean surgeries in the U.S. varies by state to state from a low of 22.6% in Utah to a high of 40.2% in Louisiana.

Variability like this is concerning to consumers because it may mean that factors are in play other than what evidence shows is best for patients. Even within these states, you’ll see incredible variations from hospital to hospital and provider to provider. Where I live, in Kentucky, the lowest hospital-level Cesarean rate in the state is below 12% and the highest is over 67%.

From “What is Practice Variation in Obstetrics and Why Should I Care?” by Adriana Arcia, PhD, RN:

“So, why should you care about practice variation? Because, “…one of the most fundamental principles in quality assessment and control is that unwarranted variation in a product or process generally equates to poor quality. Conversely, as quality improves, variation will diminish” (Clark, Belfort, Hankins, Meyers, & Houser, 2007, p. 526.e1). In other words, wide variations in care are problematic because they mean that some practitioners are making decisions that deviate from accepted best practices and therefore their patients are not getting the best quality care. Individuality of style may be good in fashion but when it comes to healthcare, consistency is a virtue.”

This map shows 2012 rates and rankings for U.S. states, with the states in five groups of ten (plus D.C.). The lowest rates of Cesarean are in the lightest color, to the highest rates in the darkest….


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