FED: "Striking" gap between private, public hospitals: study

AAP General News (Australia)
02-15-2009
FED: "Striking" gap between private, public hospitals: study

(Eds: Embargoed until 1200 AEDT, Sunday, February 15)



By Danny Rose, Medical Writer

SYDNEY, Feb 15 AAP - For every baby that dies soon after birth in an Australian private
hospital, three die in the public system.

Women who give birth in public hospitals are also more than twice as likely to suffer
tearing, or that their babies will need resuscitation, according to the alarming findings
of a new study.

Associate Professor Steve Robson and colleagues examined the outcomes of almost 790,000
births which took place over four years, and about a third were in the nation's private
hospitals.

Dr Robson said he was shocked not only by the "striking difference" between the two
systems, but also by the results that contradict a common criticism of births in private
hospitals.

"There is often a lot of criticism in the medical press of rates of caesarean birth
and rates of the induction of labour - everybody says `Wow they're so much higher in private
hospitals,'" says Dr Robson, of the Australian National University Medical School.

"And if you take the literature at face value ... all of those things ought to up the
complication rate, (but) it was lower.

"We found that quite staggering."

Dr Robson says the study raises questions about the view that some in the medical fraternity
hold that "increased rates of obstetric intervention are bad for women and their babies".

"Our study suggests these things could be beneficial because the rate of babies dying
is about half in the private hospital, and the rate of serious maternal injury is less
than half," he said.

Dr Robson said differences in the health and socio-economic status of the mothers alone
could not explain the performance gap between public and private hospitals, and that further
research was needed.

"And it's not as though we've taken a small sample, we basically looked at every birth
in the country (over four years)," he says.

The study, to be published in the Medical Journal of Australia, reported women giving
birth in public hospitals had more than twice the rate of "severe perineal tearing", and
their babies were more than twice as likely to require "high-level resuscitation" at birth.

The neonatal death rate was one for every 1,000 babies born in private hospitals, compared
to three in 1,000 in public hospitals.

The study was also undertaken by Elizabeth Sullivan and Paula Laws from the Perinatal
and Reproductive Epidemiology Research Unit, at the University of NSW.

Australia's rate of caesarean sections has risen from a single digit per cent in the
1980s to now account for more than 30 per cent of all births.

AAP dr/goc/de

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