Safety of Early Discharge for Medicaid Newborns

CONTEXT Neonates are being discharged from the hospital more rapidly, but the risks associated with this practice, especially for low-income populations, are unclear. OBJECTIVE To determine the impact of decreasing postnatal length of stay on rehospitalization rates in the immediate postdischarge pe...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 1999-09, Vol.282 (12), p.1150-1156
Main Authors: Kotagal, Uma R, Atherton, Harry D, Eshett, Rafiat, Schoettker, Pamela J, Perlstein, Paul H
Format: Article
Language:English
Subjects:
Babies
Biological and medical sciences
Births
Delivery. Postpartum. Lactation
Discharge
Gynecology. Andrology. Obstetrics
Hospitalization
Humans
Infant, Newborn
Length of Stay - economics
Length of Stay - statistics & numerical data
Likelihood Functions
Logistic Models
Maternal, fetal and perinatal monitoring
Medicaid
Medical sciences
Multivariate Analysis
neonates
Ohio - epidemiology
Outcome and Process Assessment (Health Care)
Patient Discharge - economics
Patient Discharge - statistics & numerical data
Patient Readmission - statistics & numerical data
Postnatal Care - economics
rehospitalization
Retrospective Studies
Safety
Studies
Survival Analysis
United States
USA, Ohio
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Summary:CONTEXT Neonates are being discharged from the hospital more rapidly, but the risks associated with this practice, especially for low-income populations, are unclear. OBJECTIVE To determine the impact of decreasing postnatal length of stay on rehospitalization rates in the immediate postdischarge period for Medicaid neonates. DESIGN AND SETTING Retrospective, population-based cohort study using Ohio Medicaid claims data linked to vital statistics files from July 1, 1991, to June 15, 1995. PARTICIPANTS A total of 102,678 full-term neonates born to mothers receiving Medicaid for at least 30 days after birth. MAIN OUTCOME MEASURES Rehospitalization rates within 7 and 14 days of discharge, postdischarge health care use, and regional variations in length of stay and rehospitalization. RESULTS The proportion of neonates who were discharged following a short stay (less than 1 day after vaginal delivery, less than 2 days after cesarean birth) increased 185%, from 21% to 59.8% (P
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.282.12.1150