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Innovations in Health Care Delivery
October 11, 2016

Hospital-Affiliated Outpatient Birth CentersA Possible Model for Helping to Achieve the Triple Aim in Obstetrics

Author Affiliations
  • 1Clinical Excellence Research Center, Stanford University, Stanford, California
  • 2Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Oakland, California
  • 3Department of Pediatrics, Lucile Packard Children’s Hospital, Palo Alto, California
JAMA. 2016;316(14):1441-1442. doi:10.1001/jama.2016.11770

At nearly 4 million deliveries each year, birth is one of the most common reasons women are hospitalized in the United States.1 Costs for US maternity care are among the most expensive in the world. A comparison by the International Federation of Health Plans, which represents 80 health insurance companies in 25 countries, found that payments for vaginal deliveries in the United States ($17 354) were substantially greater than those of the next highest ranked country (Switzerland, $8307).2 In addition, despite a greater cost for delivery in comparison with most other OECD (Organisation for Economic Co-operation and Development) countries, the US cesarean delivery rate is higher,3 without better birth outcomes. Worldwide, the United States ranks 48th in maternal mortality4 and 57th in infant mortality.4

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