Letter from North America: Measuring maternity care performance in the United States: The way forward

摘要

Two Institute of Medicine reports have set the stagefor the current unparalleled national focus on improvinghealth care quality and value in the United States(1,2). One exposed the chasm between the poorly performinghealth care system in the United States andthe care that could and should be routinely availableto all (1), and the other revealed endemic problemswith health care safety (2). As with the broader systemof health care, many population-level indicators ofmaternity care quality in the United States suggestpoor performance. Too many are headed in the wrongdirection, and others are stagnating. Without doubt,we can do better. An impressive body of underutilizedsystematic reviews about effects of maternity practicesprovides a basis for offering the highest standard ofeffective care with least harm (3,4).