About the National Data

Data

Baseline: 68.7 per 10,000 delivery hospitalizations had severe maternal complications in 2017

Target: 61.8 per 10,000

Numerator
Number of hospital discharges for females with any listed diagnosis or procedure indicating severe maternal complications (excluding blood transfusions).
Denominator
Number of hospital discharges for females aged 12 to 55 years who delivered one or more infants.
Target-setting method

Percent improvement

Target-setting method details
10 percent improvement from the baseline.
Target-setting method justification
Trend data were not available for this objective. A 10 percent improvement from the baseline was used to calculate a target. This method was used because there was a lack of data available to reliably estimate recent trends and because the most recent published data on severe maternal morbidity trends suggested prevalence may be increasing.

Methodology

Methodology notes

This measure follows the CDC-developed definition of severe maternal morbidity identified from hospital discharge procedure and diagnosis codes that indicate a potentially life-threatening condition or maternal complication (Callaghan et al, 2012). Specific ICD-9-CM diagnosis and procedure codes have been reduced to 21 indicators (18 if 3 are collapsed) in preparation for the transition to ICD-10-CM and described in detail by the National Center for Chronic Disease Prevention and Health Promotion, CDC.

With the exception of hospitalizations with in-hospital mortality, transfer, or severe complications identified by procedure codes (e.g., hysterectomy, blood transfusion, ventilation), cases of severe maternal morbidity identified by diagnostic codes were reclassified as hospitalizations without severe maternal morbidity if they had an implausibly short length of stay (≤ 3 days for vaginal,<4 days for primary cesarean, and < 5 days for repeat cesarean deliveries). Delivery hospitalizations were identified by diagnosis codes for an outcome of delivery, diagnosis-related group delivery codes, and procedure codes for selected delivery-related procedures (Kuklina et al, 2008).

The HCUP-NIS data represent 97% of inpatient discharges from community hospitals and do not include all states.

History

Comparable HP2020 objective
Modified, which includes core objectives that are continuing from Healthy People 2020 but underwent a change in measurement.
Changes between HP2020 and HP2030
This objective differs from Healthy People 2020 objective MICH-6 in that objective MICH-6 used data from the National Hospital Discharge Survey (NHDS - which is no longer conducted) to track maternal complications, while this objective uses data from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) to track severe maternal morbidities.