Researchers: Cost of giving birth makes no sense

An analysis of over 100,000 births in California showed such a wide variation in costs that the numbers can’t be explained by typical between-hospital variables. Published in BMJ Open, the report is a dramatic illustration of why health care is so expensive in the United States.

Researchers from the University of California, San Francisco, analyzed nearly 80,000 uncomplicated vaginal deliveries (DRG 775) and nearly 33,000 uncomplicated cesarean sections (DRG 766) performed in California in 2011. The data were from the California Office of Statewide Health Planning and Development and represented only privately insured patients.

After adjustment for patient demographics and clinical characteristics, they found that the charge for a vaginal delivery ranged from a low of $3,296 to as much as $37,227 and for a cesarean section from $8,312 to $70,908, depending on the hospital. Significantly lower charges were found at hospitals with middling competition, whereas higher adjusted charges were at hospitals with higher wages and casemixes and for-profits. Higher uninsurance rates were associated with significantly lower charges for cesarean section.  Only 35% to 36% of between-hospital variation in charges could be explained by institutional and market-level factors.

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