By Whitney Schott, Ph.D., Health Statistician and Judy George, Ph.D., Program Lead, AHRQ Quality Indicators Program, AHRQ’s Center for Quality Improvement and Patient Safety
LinkedIn: Whitney Schott
LinkedIn: Judy G.
LinkedIn: Agency for Healthcare Research and Quality
The U.S. has one of the highest maternal mortality rates in the world among wealthy nations, with an estimated 60,000 women affected each year by serious pregnancy-related complications. In response to this crisis, the United States has made improving maternal health—including maternal behavioral health—a national priority.
The crisis is particularly acute for Black women, Native women, and women in rural communities who experience the highest rates of deaths and illness from complications of labor or delivery, such as renal failure, eclampsia, heart failure, problems with anesthesia, sepsis, aneurysms, and more.
To successfully address these urgent challenges, healthcare organizations must have the ability to measure maternal morbidities and use their data for epidemiological surveillance, population health improvement, and research. State health departments, health insurance companies, policymakers, and others need reliable information about which complications are occurring, and how often.
With that need in mind, AHRQ is pleased to highlight Maternal Health Indicators (MHI), a new set of quality indicators available for analyzing trends in severe maternal morbidity. The tool from AHRQ’s Quality Indicators program allows state organizations, payers, researchers, healthcare providers, and others to track maternal morbidity trends and develop population health improvement strategies and conduct epidemiological or research studies using administrative (billing or claims) data—an especially important option for groups that may lack access to detailed clinical data.
Collaborating With Federal Partners
The MHI software, now in its testing phase, is an important example of what can be accomplished when federal agencies and external stakeholders work together.
In 2021-2022, AHRQ collaborated with the Health Services and Resource Administration (HRSA) and the Centers for Disease Control (CDC) to make publicly available a state-level measure of severe maternal morbidity. The Fast Stats dashboard, available through AHRQ’s Healthcare Cost and Utilization Project (HCUP), was an important step towards transparency on state-level rates throughout the United States.
With the goal of improving the severe maternal morbidity measure, earlier this year AHRQ issued a Request for Information seeking input from the public and stakeholders. Feedback was robust; 51 entities—local and state health officials, healthcare system leaders, hospital associations, researchers, professional organizations, and others—provided valuable insights about how to improve a claims-based measure of severe maternal morbidity.
Using all-payer billing data from HCUP, AHRQ assessed several refinements to definitions of maternal health complications during labor and delivery, such as coagulopathy and renal failure. A federal interagency workgroup, including subject matter experts from CDC, HRSA, and the Office of the Assistant Secretary for Health Office of Women’s Health, provided further feedback. AHRQ also coordinated efforts with the Centers for Medicare & Medicaid Services Center for Clinical Standards and Quality.
Launching a Tool To Measure Maternal Health Indicators
AHRQ’s new beta software to examine Maternal Health Indicators, launched in September, is intended to provide an easily accessible tool to construct area-level measures of severe maternal morbidity using readily available administrative claims data. The software allows states and other organizations to understand area-level rates of severe maternal morbidity overall and by demographic characteristics, including race/ethnicity. Organizations may also compare their rates to nationwide benchmarks. However, the software is not intended for use for comparisons across hospitals or in value-based payment programs. The measure builds on the algorithm previously used by the CDC, HRSA, and AHRQ.
Moving Maternal Health Measurement Forward
Going forward, AHRQ will collect feedback from MHI software users and continue to test new refinements in collaboration with federal agencies. Future updates to the software may include measures of post-discharge outcomes, such as extending the surveillance period for health conditions over 3, 6, and 12 months. AHRQ also plans to explore measures of mental health and substance abuse in prenatal and postnatal periods.
AHRQ is proud to contribute to ongoing federal efforts to improve maternal health. Other recent contributions by AHRQ include an HCUP statistical brief and chartbook examining trends in severe maternal morbidity complications, as well as a toolkit to support efforts by labor and delivery units to improve perinatal safety.
We encourage you to learn more about the MHI software as well as additional software modules and measures offered by AHRQ’s Quality Indicators program. AHRQ welcomes your feedback at QIsupport@ahrq.hhs.gov.
This article was originally published on AHRQ Views Blog and is republished here with permission.
