Unbiased Analysis of Today's Healthcare Issues

California Health Care Almanac

Written By: Jason Shafrin - Dec• 23•11

The California Health Care Foundation (CHCF)’s Health Care Almanac provides some unique insights on trends in health care quality in California and for the United States as a whole.  Many of the national figures for the Almanac come from the CDC (BRFSS and Vital Stats) and AHRQ’s National Healthcare Quality Report.  California quality figures come from the California Department of Public Health, the Office of Statewide Health Planning and Development and the California Health Interview Survey.

Although not discussed in this post, another portion of the Health Care Almanac looks at quality by site of service.  Much of this data comes from Hospital Compare, CMS OASIS data, AHRQ’s National Healthcare Quality Report, and the Dartmouth Atlas.

Today I highlight 3 topics related to clinical quality:

  • Cesarean Deliveries
  • Infant Mortality
  • Cancer Incidence.

More detail is below.

Cesarean Deliveries

Whereas less than one in four live births were delivered via Cesarean in 1999, in 2009, about one in three live births were delivered via Cesarean. The difference between California (33.0%) and the nation (32.9%) is tiny. Both California and the nation as a whole experienced a growth in Cesareans of over 45 percent.

Not surprisingly, two Kaiser Permanente hospitals (Redwood City, South Sacramento) have among lowest rates of Cesareans. However, Sutter David Hospital and San Francisco General (located in my neighborhood) actually have the two lowest Cesarean Delivery rates. The hospital with the worst rate of Cesareans is Los Angeles Community Hospital.

Infant Mortality

Over the past ten years, infant mortality is persistently lower in California than the U.S. Both the U.S. and California have seen an encouraging trend towards lower infant mortality rates over time.

Infant Deaths Per 1,000 Live Births

1999 2008
California 5.4 5.1
U. S. 7 6.6


Cancer Incidence

California generally has lower cancer incidence compared to the U.S. as a whole.  Most notably is the lower incidence of lung cancer.  This observation may be due in part to more strict smoking laws.

Cancer Incidence per 100,000 Population

Cancer Site California U.S.
All Sites 436.2 465.1
Prostate 148.1 156.9
Breast 122.2 120.4
Lung 50.5 65.6
Colorectal 43.2 45.5

Source: California Health Care Almanac, “Quality of Care facts and Figures: Clinical Areas.,” October 2011.

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