A Comparison of Regulatory Maternity Unit Ratings With Clinical Outcomes and Practice Measures: An Observational Study Using Routinely Collected Data Article Swipe
Ian Henderson
,
Ipek Gurol‐Urganci
,
Alissa Frémeaux
,
Alessandra Morelli
,
Kirstin Webster
,
Amar M. Karia
,
Fran Carroll
,
George A. Dunn
,
James M. Harris
,
Sam Oddie
,
Asma Khalil
,
Jan van der Meulen
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1111/1471-0528.18188
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1111/1471-0528.18188
Objective To compare inspection‐informed ratings of individual maternity units published by the Care Quality Commission (CQC) with clinical outcomes and practice measures. Design Observational study using linked national maternity and administrative hospital data. Setting The English NHS. Population Women with singleton pregnancies who gave birth at term, April 2018–March 2019. Methods Outcomes and practice measures were compared with ratings using hierarchical models and empirical Bayes estimates adjusted for case‐mix and unit characteristics. Main Outcome Measures Severe maternal and severe neonatal morbidity. Practice measures included non‐spontaneous birth (either caesarean birth before labour or the induction of labour) and intrapartum caesarean birth. Results Of 501 719 included women, 39 930 (8.0%) gave birth in 11 units rated ‘outstanding’, 357 114 (71.2%) in 110 units rated ‘good’, and 104 675 (20.9%) in 35 units rated ‘requires improvement/inadequate’. Severe maternal morbidity did not vary by rating: 1.2% [95% confidence interval 0.87–1.5], 1.3% [1.1–1.4], and 1.0% [0.87–1.1], respectively ( p = 0.59), nor did the risk of severe neonatal morbidity: 4.3% [3.3–5.6], 4.0% [3.6–4.5], and 3.4% [2.9–3.9], respectively ( p = 0.48). There was no variation across the ratings in the rate of non‐spontaneous birth (48.1% [42.2–53.9], 47.9% [46.4–49.4], and 47.9% [45.1–50.8], respectively; p = 0.87) nor intrapartum caesarean (16.8% [14.6–19.3], 16.6% [15.8–17.3], and 15.8% [14.9–16.7], respectively; p = 0.87). Conclusions There was no association between ratings of maternity units published by the national healthcare regulator and clinical outcomes and practice measures derived from routinely collected data. Concerted action is urgently needed to improve the inspection‐informed ratings of maternity services.
Related Topics
Concepts
Medicine
Observational study
Confidence interval
Singleton
Obstetrics
Caesarean section
Clinical Practice
Caesarean delivery
Population
Unit (ring theory)
Neonatal intensive care unit
Pregnancy
Pediatrics
Family medicine
Psychology
Environmental health
Pathology
Mathematics education
Genetics
Internal medicine
Biology
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1111/1471-0528.18188
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1471-0528.18188
- OA Status
- hybrid
- References
- 19
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4410136471
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4410136471Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1111/1471-0528.18188Digital Object Identifier
- Title
-
A Comparison of Regulatory Maternity Unit Ratings With Clinical Outcomes and Practice Measures: An Observational Study Using Routinely Collected DataWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-05-05Full publication date if available
- Authors
-
Ian Henderson, Ipek Gurol‐Urganci, Alissa Frémeaux, Alessandra Morelli, Kirstin Webster, Amar M. Karia, Fran Carroll, George A. Dunn, James M. Harris, Sam Oddie, Asma Khalil, Jan van der MeulenList of authors in order
- Landing page
-
https://doi.org/10.1111/1471-0528.18188Publisher landing page
- PDF URL
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1471-0528.18188Direct link to full text PDF
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YesWhether a free full text is available
- OA status
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hybridOpen access status per OpenAlex
- OA URL
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https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/1471-0528.18188Direct OA link when available
- Concepts
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Medicine, Observational study, Confidence interval, Singleton, Obstetrics, Caesarean section, Clinical Practice, Caesarean delivery, Population, Unit (ring theory), Neonatal intensive care unit, Pregnancy, Pediatrics, Family medicine, Psychology, Environmental health, Pathology, Mathematics education, Genetics, Internal medicine, BiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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19Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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