CDC LOCATe: discrepancies between self-reported level of maternal care and LOCATe-assessed level of maternal care among 463 birth facilities

Abstract

Objective: Describe sources of discrepancy between self-assessed LoMC (level of maternal care) and CDC LOCATe^®-assessed (Levels of Care Assessment Tool) LoMC.

Study design: CDC LOCATe^® was implemented at 480 facilities in 13 jurisdictions, including states, territories, perinatal regions, and hospital systems, in the U.S. Cross-sectional analyses were conducted to compare facilities' self-reported LoMC and LOCATe^®-assessed LoMC.

Result: Among 418 facilities that self-reported an LoMC, 41.4% self-reported a higher LoMC than their LOCATe^®-assessed LoMC. Among facilities with discrepancies, the most common elements lacking to meet self-reported LoMC included availability of maternal-fetal medicine (27.7%), obstetric-specializing anesthesiologist (16.2%), and obstetric ultrasound services (12.1%).

Conclusion: Two in five facilities self-report a LoMC higher than their LOCATe^®-assessed LoMC, indicating discrepancies between perceived maternal care capabilities and those recommended in current LoMC guidelines. Results highlight an opportunity for states to engage with facilities, health systems, and other stakeholders about LoMC and collaborate to strengthen systems for improving maternal care delivery.