Labor & Delivery
Total C-Section: Percent of total delivery hospitalization episodes identified as cesarean on the birth record or via APR-DRG, MS-DRG, or ICD-10-PCS codes.
Total Primary C-Section: Percent of delivery hospitalization episodes without a prior cesarean identified as cesarean on the birth record or via APR-DRG, MS-DRG, or ICD-10-PCS codes.
Total Elective Primary C-Section: Percent of delivery hospitalization episodes without a prior cesarean identified as cesarean on the birth record or via APR-DRG or MS-DRG or ICD-10-PCS codes with the exclusion of delivery hospitalization episodes with a code on the UB-04 hospital record for multiple gestations and other presentations (TJC, v2020A1, Appendix A, Table 11.09).
Primary C-Section (TJC PC-02, NTSV): This Joint Commission PC-02 Cesarean Birth Measure reflects cesareans identified by ICD-10-PCS codes among delivery hospitalization episodes limited to gestation at least 37 weeks, first-time mothers (nulliparous), singleton, ages 10 to 64, length of stay < 120 days, and excluding multiple gestations and other presentations (Appendix A, Table 11.09, v2020A1).
Total Induced Delivery (ICD-10): The percentage of total delivery hospitalization episodes with an induction as defined by induction procedure codes provided by The Joint Commission (Appendix A, Table 11.05, v2020A1).
Total Elective Induced Delivery (ICD-10): The percentage of total delivery hospitalization episodes with a potentially non-medically-indicated induction as defined by induction codes and exclusions provided by The Joint Commission (Appendix A, Tables 11.05 & 11.07, v2020A1). Caution should be taken when interpreting these data without consideration of gestation as inductions >39 weeks may not be considered elective.
Early Elective Delivery (TJC PC-01, ICD-10): The Joint Commission PC-01 Elective Delivery measure identifies the percentage of delivery hospitalization episodes that were elective at 37-38 weeks of gestation. This measure is restricted to only those singleton deliveries ages 10-64 with a length of stay < 120 days that do not have an ICD-10-CM code for conditions possibly justifying elective delivery prior to 39 weeks gestation (Appendix A, Table 11.07, v2020A1). Exclusions cannot be made for active labor or prior uterine surgery.
Early Elective Induced Delivery (ICD-10): Among singleton deliveries 37-38 weeks gestation, the percentage of delivery hospitalization episodes with a non-medically-indicated induction as defined by induction codes and exclusions provided by The Joint Commission (Appendix A, Tables 11.05 & 11.07, v2020A1). This measure is restricted to only those singleton deliveries ages 10-64 with a length of stay < 120 days. Exclusions cannot be made for active labor or prior uterine surgery.
Severe maternal morbidity (SMM) refers to life-threatening outcomes of labor and delivery. UB-04 all-payer billing data were used to calculate delivery-related SMM using ICD-10 codes associated with 21 SMM conditions, such as heart failure, renal failure, sepsis, shock, embolism, and respiratory ventilation.
These two measures are then calculated for two delivery subpopulations:
Maternal hemorrhage was identified if any of the following were present at the time of delivery:
Severe Hypertension/Preeclampsia accounts for obstetric patients with a diagnosis code for:
The 2/4/2019 AIM Data Collection Plan and 6/29/2020 AIM SMM Codes List were used to calculate these outcomes. To review the specific codes, please visit: https://safehealthcareforeverywoman.org/aim-data/
More information about the AIM initiative may be read here: What is AIM?
Maternal and newborn data were inclusive of hospitalizations from October 1, 2015 to March 31, 2020. All data records were pulled by SC RFA as of August 27, 2020. These data were restricted to only deliveries and births occurring in SC birthing facilities (i.e., data for births and deliveries to SC residents occurring outside the state of SC, at home, or in a freestanding birthing center were not included).
The maternal and newborn data were derived from three sources:South Carolina Revenue and Fiscal Affairs Office, Health and Demographics, all-payer uniformed billing data for inpatient discharges (UB-04)
In this report, all available information of births and pregnancies were retained from UB-04 and birth records data. Birth data from birth records were linked to UB-04 newborn hospitalization data, and UB-04 maternal delivery data was linked to maternal pregnancy data from the birth record. Newborn and maternal hospitalizations were aggregated to hospitalization episodes for newborns and deliveries, respectively.
The Joint Commission measures do not require this linkage of maternal hospital events with vital statistics, as some states are not set up for this level of data sharing. Linking newborn and maternal delivery hospitalization episodes with baby data and mom pregnancies from birth records, respectively, allows maximum use of the available data for newborn and maternal measures with improved accuracy of results.
What do these SC BOI data represent?
The data reflect point-in-time UB-04 data provided by individual hospitals to the SC Revenue and Fiscal Affairs Office (RFA) as of August 27, 2020, and may differ from a review of internal hospital medical records. Note: All data presented for 2019-2020 are preliminary.
What accounts for differences in denominators?
The number of births and maternal hospitalization episodes used to calculate each maternal and newborn measure or characteristic may vary due to missing data and/or measure restrictions. Newborn measures were per neonate live birth from birth records with or without linkage to a UB-04 newborn hospitalization episode. The maternal measures were per UB-04 delivery hospitalization episodes with linkage to a live birth from birth records. One delivery was counted regardless of plurality.
How were demographic data determined?
Maternal demographics, such as maternal age and residence, were as of the day of delivery.
What does it mean when there is no data for a measure?
0.00% may indicate that there were zero births in the quarter matching the measure criteria, or an actual value of zero for a specific table result. Referring to the numerators and denominators for interpretation is encouraged.
What measure and hospital definitions were used in this report?
The most recent definitions for newborn and maternal measures were used and applied across all time periods. For the early elective measures, exclusions could not be made for active labor and prior uterine surgery.
Hospital data in this report reflect naming, perinatal levels, mergers, and closures as of April 2020. Prisma Health Baptist Parkridge and Greer Memorial changed their perinatal level in 2020 and will be included in the Perinatal Level II hospital group going forward.
How are unknown and missing data treated?
For the sake of visual presentation, Unknown and Missing values are not presented in the portal. These data are, however, included in statewide and hospital totals. Therefore, subtotals in charts may not add to 100%.