1. SC DHHS Birth Outcomes Initiative Data Subcommittee

2. Members Aunyika Moonan - ORS and SC Hospital Association Chris Finney - ORS Heather Kirby - ORS Shea Sutton - DHEC Daniela Nitcheva - DHEC Laurel Eddins - SCDHHS Dr. Tom Hulsey, MUSC Ad hoc, Dr George Helmrich (GHS) & Dr. Laura Goetzl (MUSC).

3. Goals Document baseline rate of ‘Elective Cesarean’ deliveries in South Carolina and monitor changes over time; by hospital Assist other subcommittees with access and interpretation of data needs Respond, as requested, to meet data needs for any BOI activity

4. Reduce the Number of ‘Elective Cesarean’ Deliveries between 37 and 38 weeks gestation Approximately 1/3 of these deliveries are ‘Elective’ Increased admission to NICU Longer length of hospitalization Increased costs

5. Steps to Monitor Elective Cesarean Merge UB04 Hospitalization Data (ORS) with Vital Records (DHEC) to obtain gestational age for each delivery Baseline: 2009 & 2010 Subset to 37 and 38 weeks gestation Identify associated ICD9 codes with each delivery

6. Identify Elective Cesareans Specifications Manual for Joint Commission National Quality Measures (v2010B2) Table 11.05 provides ICD9 (+ V) codes for 78 conditions that are Medical Indications for Induction or Cesarean (these were emailed yesterday by the Hospital Association ) Cesareans without one of these codes is operationally defined as ‘Elective’

7. Exclusions Excludes stay over 119 days; Excludes ages 64; Excludes specific categories indicating Medically Indicated Cesarean Deliveries

8. Next Steps Resolve Discrepancies with Gestational Age reporting methods Resolve exclusions from the ‘Medically Indicated’ list Maintain the high level of inter-agency collaboration initiated by DHHS (BOI) Maintain active involvement of physicians and hospitals to continue joint ownership