Risk-Adjusted Measurement of Primary Cesarean Sections: PDF OnlyRisk-Adjusted Measurement of Primary Cesarean Sections Reliable Assessment of the Quality of Obstetrical ServicesPasternak, Derick P.; Pine, Michael; Nolan, Kevin; French, RhondaAuthor Information The authors wish to thank Alec Dinwoodie for his editorial assistance with this article. Derick Pasternak, MD, MBA,is Chief Executive Officer of Medalia HealthCare LLC, a physician practice group based in Seattle, Washington. Michael Pine, MD, MBA,is a Research Associate at the University of Chicago and President of Michael Pine and Associates, Inc., a Chicago-based consulting firm. Kevin Nolanis Chief Executive Officer of Humility of Mary Health System in Ohio. Rhonda French, MSN, RN/CS, CNP, CCRN,is a Cardiovascular Clinical Nurse Specialist at St. Elizabeth Health Center in Youngstown, Ohio. Quality Management in Health Care: Volume 8 - Issue 1 - p 47-54 Buy Abstract A two-hospital system reported widely disparate Cesarean section rates in its component institutions. Statistical analysis determined that the apparent discrepancy was due primarily to patient-related factors. When risk-adjusted, both hospitals' rates were indistinguishable from expected rates. Reporting Cesarean section rates without appropriate risk adjustment yields potentially misleading results. Since reliable risk adjustment currently exists only for primary Cesarean sections, primary rates should be reported separately from “raw” rates for other procedures. ©1999Aspen Publishers, Inc.