Effects of a law against early postpartum discharge on newborn follow-up, adverse events, and HMO expenditures.
Effects of a law against early postpartum discharge on newborn follow-up, adverse events, and HMO expenditures.
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DOI：
10.1056/nejmsa020408
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发表时间：
2002-12-19
影响因子：
158.5
通讯作者：
Ross-Degnan, D
中科院分区：
文献类型：
--
作者：
Madden, JM;Soumerai, SB;Ross-Degnan, D
背景：由于担心产后早期出院对新生儿的伤害，20世纪90年代中期制定了规定最低住院时间的法律。我们评估了提前出院方案的效果（产后一晚的住院加家访）在健康维护组织（HMO）和随后的州法律保证48小时住院。方法：使用中断时间序列分析和20,366对正常阴道分娩的母婴数据，我们测量了住院时间的变化，新生儿出生后第三天或第四天的检查，以及门诊、急诊和新生儿再入院。结果：早出院方案使住院少于两晚的比例从29.0%提高到65.6%（P
Background: Concern about harm to newborns from early postpartum discharges led to laws establishing minimum hospital stays in the mid-1990s. We evaluated the effects of an early-discharge protocol (a hospital stay of one postpartum night plus a home visit) in a health maintenance organization (HMO) and a subsequent state law guaranteeing a 48-hour hospital stay.Methods: Using interrupted-time-series analysis and data on 20,366 mother-infant pairs with normal vaginal deliveries, we measured changes in length of stay, newborn examinations on the third or fourth day of life, and office visits, emergency department visits, and hospital readmissions for newborns. We also examined expenditures for hospitalizations and home-based care.Results: The early-discharge program increased the rate of stays of less than two nights from 29.0 percent to 65.6 percent (P