ArticlePloS one2019
Monitoring quality of obstetric care from hospital discharge databases: A Delphi survey to propose a new set of indicators based on maternal health outcomes.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Perioperative quality indicators specific to the practice of anesthesia in noncardiac surgery: an umbrella review.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Pooled it
- Detection of obstetric anal sphincter injuries: From the fear of malpractice to a quality indicator of a center.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Review
- Monitoring childbirth and immediate postpartum care quality: A scoping review of indicators in high-income countries.PloS one · 2026Article
- Quality indicators for rural surgical and obstetrical care: A modified Delphi consensus study.PloS one · 2025Article
- Severe adverse maternal and neonatal outcomes according to the planned birth setting being midwife-led birth centers or obstetric-led units.Acta obstetricia et gynecologica Scandinavica · 2024Article
- How other countries can improve Canada's maternal mortality statistics.Obstetric medicine · 2023Review
- Development of a set of quality indicators in paediatric and perinatal care in Japan with a modified Delphi method.BMJ paediatrics open · 2023Article
- Development and early validation of questionnaires to assess system level factors affecting male partners' attendance at childbirth in LMICs.BMC pregnancy and childbirth · 2023Article
- Quality Indicators during Delivery and the Immediate Postpartum Period: A Modified Delphi Study.Healthcare (Basel, Switzerland) · 2023Article
- Selecting Performance Indicators and Targets in Health Care: An International Scoping Review and Standardized Process Framework.Risk management and healthcare policy · 2022Article
- Resilience and vulnerability of maternity services in Zimbabwe: a comparative analysis of the effect of Covid-19 and lockdown control measures on maternal and perinatal outcomes, a single-centre cross-sectional study at Mpilo Central Hospital.BMC pregnancy and childbirth · 2021Observational
- Variations in use of childbirth interventions in 13 high-income countries: A multinational cross-sectional study.PLoS medicine · 2020Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMost indicators proposed for assessing quality of care in obstetrics are process indicators and do not directly measure health effects, and cannot always be identified from routinely available databases. Our objective was to propose a set of indicators to assess the quality of hospital obstetric care from maternal morbidity outcomes identifiable in permanent hospital discharge databases.
methodsVarious maternal morbidity outcomes potentially reflecting quality of obstetric care were first selected from a systematic literature review. Then a three-round Delphi consensus survey was conducted online from 11/2016 through 02/2017 among a French panel of 37 expert obstetricians, anesthetists-critical-care specialists, midwives, quality-of-care researchers, and user representatives. For a given maternal outcome, several definitions could be proposed and the indicator (i.e. corresponding rate) could be applied to all women or restricted to specific subgroup(s).
resultsOf the 49 experts invited to participate, 37 agreed. The response rate was 92% in the second round and 97% in the third. Finally, a set of 13 indicators was selected to assess the quality of hospital obstetric care: rates of uterine rupture, postpartum hemorrhage, transfusion incident, severe perineal lacerations, episiotomy, cesarean, cesarean under general anesthesia, post-cesarean site infection, anesthesia-related complications, postpartum pulmonary embolism, maternal readmission and maternal mortality. Six were considered in specific subgroups, with, for example, the postpartum hemorrhage rate assessed among all women and also among women at low risk of PPH. IMPLICATIONS: This Delphi process enabled us to define consensually a set of indicators to assess the quality of hospital obstetrics care from routine hospital data, based on maternal morbidity outcomes. Considering 6 of them in specific subgroups of women is especially interesting. These indicators, identifiable through codes used in international classifications, will be useful to monitor quality of care over time and across settings.
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