The hospital data presented on Cal Hospital Compare is the result of a partnership among independent organizations dedicated to improving health care quality. American Institutes for Research (AIR) provides data support and analysis. AIR delivers unbiased information, analytic tools, benchmarks, and services to hospitals, government agencies, employers, health plans, clinicians, and pharmaceutical and medical device companies. Cal Hospital Compare also partners with the California Maternal Quality Care Collaborative’s Maternal Data Center (CMQCC’s MDC) to obtain data on hospitals that provide maternity services. These ratings are published on our website to support transparency and informed decision-making.
Mother & Baby
- Breastfeeding Rate (CDPH): California Department of Public Health
Reporting Period for other Mother & Baby Measures (listed below):
The ratings reflect the 2023 calendar year hospital discharge and birth certificate data from 204 California hospitals that offer maternity services and participate in the CMQCC’s MDC. These 204 hospitals submitted data to the CMQCC Maternal Data Center to enable rapid-cycle reporting and quality improvement. One hospital listed in this section did not submit data to the CMQCC Maternal Data Center; their results represent Calendar Year 2022 data available from the California Department of Health Care Access and Information. There are 13 other hospitals that have closed. These hospitals are listed here.
State Average – this average represents the 95% of 2023 California deliveries reported to the CMQCC Maternal Data Center.
- Cesarean Birth Rate (NTSV): CMQCC; rates based on Patient Discharge Data submitted by each hospital to the CMQCC Maternal Data Center and linked to Birth Certificate Data from the California Department of Public Health-Vital Records*. Performance categories developed by Cal Hospital Compare. Measure specifications: Joint Commission PC-02 (See Manual)
- Episiotomy Rate: CMQCC; based on Patient Discharge Data submitted by each hospital to the CMQCC Maternal Data Center; Performance categories developed by Cal Hospital Compare. Measure specifications: National Quality Forum 0470 (NQF)
- VBAC Rate: CMQCC based on Patient Discharge Data submitted by each hospital to the CMQCC Maternal Data Center.* Performance categories developed by Cal Hospital Compare. Measure specifications: Agency for Healthcare Research and Quality Inpatient Quality Indicator AHRQ IQI 22 (See Measure Description)
- This VBAC Routinely Available information was collected from a survey of hospitals conducted by the Hospital Quality Institute in 2016 and is regularly updated by the California Maternal Quality Care Collaborative upon hospital request. However, policies can change, so please contact the hospital directly to learn their current policy on VBACs.
- Deliveries by Certified Nurse Midwives: CMQCC; rates based Patient Discharge Data submitted to the CMQCC Maternal Data Center and linked to Birth Certificate Data from the California Department of Public Health-Vital Records*.
* Any analyses, interpretations, or conclusions reached regarding these results reflect those of the author and not CMQCC or CDPH.
Hip & Knee
- CMS Hospital Compare
- California Department of Health Care Access and Information
Patient Safety
- CMS Hospital Compare
- California Department of Health Care Access and Information
Healthcare Acquired Infections (HAIs)
- CDPH
Cancer Surgery
- CDPH
- California Department of Health Care Access and Information
Emergency Department (ED) Care
- CMS Hospital Compare
Heart & Lung Conditions
- CMS Hospital Compare
- California Department of Health Care Access and Information
Surgeries/Other Conditions
- California Department of Health Care Access and Information
Stroke
- CMS Hospital Compare
Psychiatric measures
- CMS Hospital Compare
- Cal Hospital Compare reports psychiatric measures for adult, acute care hospitals with dedicated inpatient behavioral health services and for standalone psychiatric hospitals.
About the Ratings & Data Sources
To produce the hospital information available on Cal Hospital Compare, a rigorous process is followed:
- Data are gathered by AIR from publicly available sources.
- Data are then compared to a benchmark value, either a national, state, or Cal Hospital Compare standard.
- Ratings are assigned to measures when it is technically feasible (for example, a large enough sample or an accepted risk-adjustment approach) and there is an appropriate standard.
Guidelines established by a technical oversight committee and expert statisticians determine how the data are processed.
Risk-Adjustment Methods
Some patients respond better to treatment than others. For example, having diabetes can reduce your chances of surviving heart surgery. So it would not be fair for a hospital with more diabetic patients to have a worse rating just because they treat more sick patients. “Risk adjustment” is the process that levels the playing field among hospitals to fairly compare hospital performance.
Some measures do not need to be risk adjusted. For example, having diabetes does not prevent the nurse from checking your wristband before giving a medication, so there should be no adjustment for diabetes in that measure. The organizations providing the data determine whether risk adjustment is applied to the measures. In general, the effect of the risk-adjustment process on hospital scores is small.
Applying a Margin of Error to Data
Another way to make sure that fair comparisons can be made between different hospitals is to apply a “margin of error.” This helps compare hospitals that perform very few procedures with those that perform many. For example, a hospital that does only one heart surgery will have a death rate of either 0% (if the patient lives) or 100% (if the patient dies). Based on the outcome for one patient, it is difficult to determine how the hospital would perform for many surgeries on many patients. So we apply a wide margin of error that says the death rate is not very reliable because it is based on just one case.
For hospitals that have only a few patients with a particular condition, their margin of error in that condition is broad, while for hospitals with hundreds of patients the margin for error is narrow. For this reason, for any single measure on this site, two hospitals with the same rating may have very different percentages shown. In rating the hospitals, the margin of error is taken into account by calculating an estimated range of hospital performance for each condition, with the range wider for hospitals with fewer patients and narrower for hospitals with many patients.
Performance Ratings
The performance rating icons indicate how well a hospital performed compared with other hospitals. Depending on the type of measure, the scale will use all five (superior, above average, average, below average, and poor) or only three of these ratings (superior, average, and poor).
Case Volume Ratings
Research has shown that the more cases a hospital handles for a particular procedure, then the surgical team has more practice, which may lead to better results for the patients. This website provides case volume ratings for some surgical procedures. Hospitals are rated as either having “enough cases” or “not enough cases.” To determine the rating, the hospital reports the number of cases performed and it is compared to a specific “cut point” as determined by medical research. For hospitals that meet the cut point, the website also shows the risk-adjusted death rate for the procedure. For the cancer surgery volume data presented, no ratings or cut points are provided given that the medical research is not conclusive regarding an exact cut point.
