Lower Hudson Valley Perinatal Network

Serving Dutchess, Putnam, Rockland & Westchester Counties

 

Presented at the

Quarterly Education & Networking Conference

January 22, 2008

Optimizing Birth: A Tale of Two Delivery Modes

Lower Hudson Valley Perinatal Data Book: Delivery Rates Over Time – 2000-2005

• Level 1 hospitals provide care to normal and low-risk pregnant women and newborns, and they do not operate neonatal intensive care units (NICU); Must transfer infants who:

– Gestation ≤ 36 weeks– Birth weight ≤ 2500 grams – Major problems requiring “advanced laboratory, radiologic, or consultation services”– Require ventilation above immediate resuscitation

• Level 2 hospitals provide care to women and newborns at moderate risk and do operate NICUs;Must transfer infants who:

– Gestation ≤ 30 weeks– Birth weight ≤ 1250 grams– Require ventilation more than 7 days

• Level 3 hospitals care for patients requiring increasingly complex care and operate NICUsMust transfer infants who:

– Require specialized services such as high frequency ventilator or ECMO

NYS Hospitals and Perinatal Designation Level

Research strongly supports regionalization as a means of improving maternal and infant outcomes. Perinatal regionalization represents the continuum of care that ensures that all pregnant women, fetuses and newborns have timely access to care. New York State's system of regionalized perinatal services includes a hierarchy of four levels of perinatal care provided by the hospitals within a region and led by a Regional Perinatal Center (RPC).

The regional system is led by an RPC that is capable of providing all the services and expertise required by the most acutely sick or at-risk pregnant women and newborns. The concentration of high-risk patients makes it possible to enhance and maintain the level of expertise in the care of high-risk obstetric and neonatal patients, as well as justify the substantial expense required to establish and maintain neonatal intensive care units and attending-level subspecialty consultation. RPCs provide or coordinate maternal-fetal and newborn transfers of high-risk patients from their affiliate hospitals to the RPC, and are responsible for support, education, consultation and improvements in the quality of care in the affiliate hospitals within their region.

The four levels of perinatal care within the regionalization system vary by the types of patients that are treated, availability of sub-specialty consultation, qualifications of staff, types of equipment available and volume of high-risk perinatal patients treated. Besides the RPC, there are three other levels of care:

Adapted from http://www.health.state.ny.us/community/pregnancy/health_care/perinatal/hospital_designations.htm

2000-2005 Hospital Total C-section Rates in Dutchess County

0.0%

10.0%

20.0%

30.0%

40.0%

2000 2001 2002 2003 2004 2005

Year

% o

f C

-se

cti

on

s p

er

Ho

sp

ita

l

North Dutchess Hospital - Level 1

Vassar Brothers Medical Center- Level 3

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2005 & Vital Statistics Data, 2000-2005, and CDC National Statistics Reports, Births: Final Data, 2000-2005.

2000-2005 Total C-section Rates by Region Type

0.0%

10.0%

20.0%

30.0%

40.0%

2000 2001 2002 2003 2004 2005

Year

% o

f T

ota

l C-s

ec

tio

ns

pe

r R

eg

ion

Ty

pe

Dutchess

All NYS

National

2000-2003 Hospital Primary C-section Rates in Dutchess County

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

2000 2001 2002 2003

Year

% P

rim

ary

C-s

ec

tio

ns

pe

r H

os

pit

al

North Dutchess Hospital -Level 1

Vassar Brothers MedicalCenter - Level 3

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003.

Data not available for 2004 and 2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003 & Vital Statistics Data, 2000-2003, and CDC National Statistics Reports, Births: Final Data, 2000-2003.

2000-2003 Primary C-section Rates by Region Type

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

2000 2001 2002 2003

Year

% P

rim

ary

C-s

ecti

on

s p

er R

egio

n T

ype

Dutchess

All NYS

National

County, NYC, Rest of NYS & All NYS data not available for 2004 and 2005; 2004 and 2005 National data are available from the CDC National Statistics Reports on Births for those years.

2000-2003 Hospital VBAC Rates in Dutchess County

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

2000 2001 2002 2003

Year

% V

BA

Cs

pe

r H

os

pit

al

North Dutchess Hospital -Level 1

Vassar Brothers MedicalCenter - Level 3

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003.

Data not available for 2004 and 2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003 & Vital Statistics Data, 2000-2003, and CDC National Statistics Reports, Births: Final Data, 2000-2003.

2000-2003 VBAC Rates by Region Type

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

2000 2001 2002 2003

Year

% V

BA

Cs

per

Reg

ion

Typ

e

Dutchess

All NYS

National

County, NYC, Rest of NYS & All NYS data not available for 2004 and 2005; 2004 and 2005 National data are available from the CDC National Statistics Reports on Births for those years.

2000-2005 Hospital Total C-section Rates in Putnam County

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

2000 2001 2002 2003 2004 2005

Year

% o

f C

-sec

tio

ns

Putnam HospitalCenter - Level 1

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2005 & Vital Statistics Data, 2000-2005, and CDC National Statistics Reports, Births: Final Data, 2000-2005.

2000-2005 Total C-section Rates by Region Type

0.0%

10.0%

20.0%

30.0%

40.0%

2000 2001 2002 2003 2004 2005

Years

% o

f T

ota

l C-s

ec

tio

ns

pe

r R

eg

ion

Ty

pe

Putnam

All NYS

National

2000-2005 Hospital Primary C-section Rates in Putnam County

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

2000 2001 2002 2003

Year

% P

rim

ary

C-s

ecti

on

s

Putnam HospitalCenter - Level 1

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003.

Data not available for 2004 and 2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003 & Vital Statistics Data, 2000-2003, and CDC National Statistics Reports, Births: Final Data, 2000-2003.

2000-2003 Primary C-section Rates by Region Type

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

2000 2001 2002 2003

Year

% P

rim

ary

C-s

ecti

on

s p

er R

egio

n T

ype

Putnam

All NYS

National

County, NYC, Rest of NYS & All NYS data not available for 2004 and 2005; 2004 and 2005 National data are available from the CDC National Statistics Reports on Births for those years.

2000-2003 Hospital VBAC Rates in Putnam County

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

2000 2001 2002 2003

Year

% V

BA

Cs

Putnam HospitalCenter - Level 1

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003.

Data not available for 2004 and 2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003 & Vital Statistics Data, 2000-2003, and CDC National Statistics Reports, Births: Final Data, 2000-2003.

2000-2003 VBAC Rates by Region Type

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

2000 2001 2002 2003

Year

% V

BA

Cs p

er

Reg

ion

Typ

e Putnam

All NYS

National

County, NYC, Rest of NYS & All NYS data not available for 2004 and 2005; 2004 and 2005 National data are available from the CDC National Statistics Reports on Births for those years.

2000-2005 Hospital Total C-section Rates in Rockland County

0.0%

10.0%

20.0%

30.0%

40.0%

2000 2001 2002 2003 2004 2005

Year

% o

f C

-sec

tio

ns

per

Ho

spit

al Good SamaritanHospital - Level 2

Nyack Hospital -Level 2

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2005 & Vital Statistics Data, 2000-2005, and CDC National Statistics Reports, Births: Final Data 2000-2005.

2000-2005 Total C-section Rates by Region Type

0.0%

10.0%

20.0%

30.0%

40.0%

2000 2001 2002 2003 2004 2005

Year

% o

f T

ota

l C

-sec

tio

ns

per

Reg

ion

Typ

e

Rockland

All NYS

National

2000-2003 Hospital Primary C-section Rates in Rockland County

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%

2000 2001 2002 2003

Year

% P

rim

ary

C-s

ec

tio

ns

pe

r H

os

pit

al

Good Samaritan Hospital - Level 2

Nyack Hospital - Level 2

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003.

Data not available for 2004 and 2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003 & Vital Statistics Data, 2000-2003, and CDC National Statistics Reports, Births: Final Data 2000-2003.

2000-2003 Primary C-section Rates by Region Type

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

2000 2001 2002 2003

Year

% P

rim

ary

C-s

ec

tio

ns

pe

r R

eg

ion

Ty

pe

Rockland

All NYS

National

County, NYC, Rest of NYS & All NYS data not available for 2004 and 2005; 2004 and 2005 National data are available from the CDC National Statistics Reports on Births for those years.

2000-2003 Hospital VBAC Rates in RocklandCounty

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

2000 2001 2002 2003

Year

% V

BA

Cs

pe

r H

os

pit

al

Good Samaritan Hospital -Level 2

Nyack Hospital - Level 2

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003.

Data not available for 2004 and 2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003 & Vital Statistics Data, 2000-2003, and CDC National Statistics Reports, Births: Final Data, 2000-2003.

2000-2003 VBAC Rates by Region Type

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

2000 2001 2002 2003

Year

% V

BA

Cs

per

Reg

ion

Typ

e

Rockland

All NYS

National

County, NYC, Rest of NYS & All NYS data not available for 2004 and 2005; 2004 and 2005 National data are available from the CDC National Statistics Reports on Births for those years.

2000-2005 Hospital Total C-section Rates in Northern Westchester County*

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

2000 2001 2002 2003 2004 2005

Year

% o

f C

-se

cti

on

s p

er

Ho

sp

ita

l

Hudson Valley HospitalCenter - Level 2

Northern WestchesterHospital - Level 2

Phelps Memorial HospitalAssociation - Level 1

Westchester Medical Center- Level 4

* Northern Westchester County constitutes the area above Interstate 287.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2005.

2000-2005 Hospital Total C-section Rates in Southern Westchester County*

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

2000 2001 2002 2003 2004 2005

Year

% o

f C

-se

cti

on

s p

er

Ho

sp

ita

l

Lawrence Hospital Center -Level 2

Sound Shore MedicalCenter of Westchester -Level 3

St. John's RiversideHospital - Level 2

White Plains HospitalCenter - Level 3

* Southern Westchester County constitutes the area below Interstate 287.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2005 & Vital Statistics Data, 2000-2005, and CDC National Statistics Reports, Births: Final Data 2000-2005.

2000-2005 Total C-section Rates by Region Type

0.0%

10.0%

20.0%

30.0%

40.0%

2000 2001 2002 2003 2004 2005

Year

% o

f T

ota

l C

-sec

tio

ns

per

Reg

ion

Typ

e

All Westchester

All NYS

National

2000-2003 Hospital Primary C-section Rates in Northern Westchester County*

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

2000 2001 2002 2003

Year

% P

rim

ary

C-s

ec

tio

ns

pe

r H

os

pit

al

Hudson Valley HospitalCenter - Level 2

Northern WestchesterHospital - Level 2

Phelps Memorial HospitalAssociation - Level 1

Westchester MedicalCenter - Level 4

* Northern Westchester County constitutes the area above Interstate 287.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003.

Data not available for 2004 and 2005.

2000-2003 Hospital Primary C-section Rates in Southern Westchester County*

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

2000 2001 2002 2003

Year

% P

rim

ary

C-s

ec

tio

ns

pe

r H

os

pit

al

Lawrence Hospital Center- Level 2

Sound Shore MedicalCenter of Westchester -Level 3St. John's RiversideHospital - Level 2

White Plains HospitalCenter - Level 3

* Southern Westchester County constitutes the area below Interstate 287.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003.

Data not available for 2004 and 2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003 & Vital Statistics Data, 2000-2003, and CDC National Statistics Reports, Births: Final Data 2000-2003.

2000-2003 Primary C-section Rates by Region Type

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

2000 2001 2002 2003

Year

% P

rim

ary

C-s

ec

tio

ns

pe

r R

eg

ion

Ty

pe

AllWestchester

All NYS

National

County, NYC, Rest of NYS & All NYS data not available for 2004 and 2005; 2004 and 2005 National data are available from the CDC National Statistics Reports on Births for those years.

2000-2003 Hospital VBAC Rates in Northern Westchester County*

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%

2000 2001 2002 2003

Year

% V

BA

Cs

pe

r H

os

pit

al

Hudson Valley HospitalCenter - Level 2

Northern WestchesterHospital - Level 2

Phelps Memorial HospitalAssociation - Level 1

Westchester Medical Center -Level 4

* Northern Westchester County constitutes the area above Interstate 287.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003.

Data not available for 2004 and 2005.

2000-2003 Hospital VBAC Rates in Southern Westchester County*

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

2000 2001 2002 2003

Year

% V

BA

Cs

pe

r H

os

pit

al

Lawrence Hospital Center -Level 2

Sound Shore Medical Centerof Westchester - Level 3

St. John's Riverside Hospital -Level 2

White Plains Hospital Center -Level 3

* Southern Westchester County constitutes the area below Interstate 287.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003.

Data not available for 2004 and 2005.

Source: NYS Department of Health, Maternity Information Pamphlet Data, 2000-2003 & Vital Statistics Data, 2000-2003, and CDC National Statistics Reports, Births: Final Data, 2000-2003.

2000-2003 VBAC Rates by Region Type

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

2000 2001 2002 2003

Year

% V

BA

Cs

per

Reg

ion

Typ

e

AllWestchester

All NYS

National

County, NYC, Rest of NYS & All NYS data not available for 2004 and 2005; 2004 and 2005 National data are available from the CDC National Statistics Reports on Births for those years.

For more information on the data presented in this Data Book please contact the Lower

Hudson Valley Perinatal Network at

info@lhvpn.net or (914) 493-6435.