Maternity Care Quality Data Visualization Challenge

Exposing Variations in Maternity Care Quality, Health Outcomes, and Value


Maternity care is a major segment of the health care system. With over 4 million births annually, 23% of those discharged from U.S. hospitals are childbearing women and newborns, making maternity care by far the most common hospital condition and a leading reason for outpatient visits. Charges for maternal-newborn care far exceed those for any other hospital condition, involving $98 billion in hospital fees alone in 2008.

Cesarean section, major surgery with risks that include wound infection, hemorrhage, rehospitalization, life-threatening complications in subsequent pregnancies, and neonatal respiratory problems, is the most common operating room procedure in the United States. The 2009 cesarean rate of 32.9% marked the 13th consecutive year of increase and a record-level national rate. The cesarean rate varied across states in 2007, from a low of 22% in Utah to a high of 38% in New Jersey. It reached 49% in Puerto Rico. Where facility and provider-level data are available, marked variation in cesarean rates has also been demonstrated, and studies suggest that little of the variation has to do with the health, risk status, or preferences of women.

Intermountain Healthcare, widely regarded as a leader in the maternity care quality movement, recently estimated that the U.S. would save $3.5 billion in hospital fees alone if the national c-section rate matched the Intermountain rate of 21%.

Additionally, the Intermountain analysis does not take into consideration the fact that charges for both vaginal and cesarean births also vary across states. For example, a recent analysis by Childbirth Connection using data from AHRQ’s Health Costs and Utilization Project demonstrated that California hospitals charge 50-66% more for vaginal and cesarean births than the average U.S. hospital does.

Reducing the excess use of cesarean section and reining in cost variation is just one step toward vast improvement in the quality and value of maternity care in the U.S. In 2010, health care leaders convened by Childbirth Connection described a consensus “2020 Vision for a High Quality, High-Value Maternity Care System” and issued a “Blueprint for Action,” charting the path toward that vision.

Successful implementation of the Blueprint will require commitment by state-level policy makers and advocates, who need robust and nimble information systems to identify areas for improvement and measure progress. Many important maternity care data, especially facility- and provider-level data, are inconsistently collected and reported. Other data are available but remain tucked away in disparate databases and reports.

Challenge

Create a data visualization tool that demonstrates geographic variation in access, procedures use, outcomes, and/or costs in maternity care to galvanize state and regional action for quality improvement.

We are looking for entries that make the data engaging and relevant for policy makers, grassroots advocates, the media, and other stakeholders. High priority data include cesarean rates, hospital charges, proportion of midwife-attended births, geographic availability of birth centers, geographic availability of facilities supporting vaginal birth after cesarean, rates of elective delivery, payer source (private or Medicaid), and racial and ethnic disparities in access, outcomes, and procedure use. We encourage developers to incorporate other data as well, enabling multiple or dynamic visualizations.

Judging

Applications must include:

  • A narrative description including: name, contact information, and organizational affiliation (if any) of all team members.
  • A description of the health problem
  • The applicant’s addresses
  • Instructions for use of the application
  • A live (via web conference) or video-recorded demonstration of the data visualization application

Applications will be judged based on:

  • Ability to convey data in an accurate, meaningful and creative manner
  • Overall design and user experience
  • Use of high priority data sets
  • Additional Resources

Data

  • National Inpatient Sample of HCUP: http://www.hcup-us.ahrq.gov/nisoverview.jsp
  • VitalStats (birth certificate data): http://www.cdc.gov/nchs/VitalStats.htm
  • National Survey of Family Growth: http://www.cdc.gov/nchs/nsfg/abc_list.htm
  • Pregnancy Risk Assessment Monitoring System (requires application to use data): http://www.cdc.gov/prams/index.htm
  • State Health Facts from Kaiser (maternity coverage): http://www.statehealthfacts.org/profileind.jsp?ind=687&cat=7&rgn=1
  • Maternity Practices in Infant Nutrition and Care (mPINC) (breastfeeding data): http://www.cdc.gov/breastfeeding/data/mpinc/index.htm
  • VBAC Policy database: http://ican-online.org/vbac-ban-info
  • Childbirth Connection’s Listening to Mothers data: http://arc.irss.unc.edu/dvn/dv/odvn/faces/StudyListingPage.xhtml?mode=1&collectionId=629
  • List of AABC-accredited birth centers: http://www.birthcenters.org/find-a-birth-center/
  • List of Baby-Friendly Hospitals: http://babyfriendlyusa.org/eng/03.html

State web sites with facility-level maternity data include:

  • California: http://www.calhospitalcompare.org/
  • Massachusetts: http://hcqcc.hcf.state.ma.us/Default.aspx
  • New York: http://hospitals.nyhealth.gov/index.php
  • Virginia (also provides provider-level data):http://www.vhi.org/ob_reports.asp
  • Wisconsin: http://www.wicheckpoint.org/

Other states may be available. One blogger has obtained hospital-level c-section rates for the 15 states for which data were attainable: http://www.theunnecesarean.com/blog/2010/9/1/cesarean-rate-posts-on-the-unnecesarean.html

Terms and Conditions

All applications must include:

A narrative description including:

  • name, contact information, and organizational affiliations (if any) of all team members.
  • a description of the health problem
  • applicant’s addresses
  • instructions for use of the application
  • A live (via web conference) or video-recorded demonstration of the data visualization application

Eligibility

Entrants in the Challenge (each, an “Entrant”) must satisfy the following eligibility criteria:

  • The Challenge is open only to legal residents of the fifty (50) states of the United States and the District of Columbia and entities organized under the laws of the fifty (50) states of the United States and the District of Columbia.
  • Entrants who are individuals must be at least eighteen (18) years of age as of the time of entry; and
  • Affiliated Persons (as defined below) are ineligible to participate in the Challenge
  • As used herein, the term "Affiliated Persons" means (a) the trustees, directors, officers, shareholders, members, employees, contractors, agents, representatives and affiliates of the Sponsor and any entity associated with the funding, administration or processing of the Challenge and (b) the members of the Immediate Family (as defined below) of any of the persons identified in clause (a). The term "Immediate Family" includes a person's spouse/domestic partner and the parents, siblings, children and grandchildren of the person and his or her spouse/ domestic partner.

License

Winner gives Childbirth Connection a royalty-free non-exclusive worldwide license to use, copy for use, perform publicly, display publicly, applications developed as part of the challenge for the purpose of the Competition for three (3) years after the announcement of winners.

Limitation of Liability

Entrants agree that the sponsor and the affiliated persons shall not be responsible or liable for damages or losses of any kind arising out of or resulting from entry and participation in this challenge, acceptance or use of a prize or any other matter related to this challenge, including, without limitation, claims based on property damage, violation of intellectual property rights, personal injury and/or death, publicity rights, taxes or other duties, defamation or invasion of privacy or any other legal claims.

Deadline for Submissions

  • March 07, 2011 11:59PM EST

    Results

    The winning visualization: Mapping Maternity Care And Birth Outcomes by Damien Leri and Ian Bennett.




Challenge Updates

Receive challenge updates and announcements directly: sign up for our Challenge News mailing list.
Note: this is separate from our normal mailing list.

Sign Up for Challenge Updates