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Pediatrics. 2003 Feb;111(2):364-71.

Newborn early discharge revisited: are California newborns receiving recommended postnatal services?

Author information

1
Robert Wood Johnson Clinical Scholars Program, University of Washington, Seattle, Washington 98195-7183, USA. agalb@u.washington.edu

Abstract

CONTEXT:

Responding to safety concerns, federal and state legislation mandated coverage of minimum postnatal stays and state legislation in California mandated coverage of follow-up after early discharge. Little is known about the postnatal services newborns are receiving.

OBJECTIVE:

To describe rates of early discharge and of timely follow-up for early-discharged newborns.

DESIGN AND SETTING:

Retrospective, population-based cohort study using a 1999 postpartum survey in California.

PARTICIPANTS:

A total of 2828 infants of mothers with medically low-risk singleton births.

MAIN OUTCOME MEASURES:

Rates of early discharge (<or=1-night stay after vaginal delivery and <or=3-night stay after cesarean section) and untimely follow-up (no home or office visit within 2 days of early discharge).

RESULTS:

Overall, 49.4% of newborns were discharged early. Of these, 67.5% had untimely follow-up. The odds of early discharge were greater with lower incomes: the adjusted odds ratios (AORs) (with 95% confidence intervals) were 2.06 (1.50-2.83) for incomes <or=100% of poverty, 2.20 (1.65-2.93) for incomes from 101%-200% of poverty, and 2.24 (1.63-3.08) for incomes from 201%-300% of poverty. Untimely follow-up was more likely for infants of women with incomes <or=100% of poverty (AOR = 1.89 [1.13-3.17]) and 201%-300% of poverty (AOR = 1.78 [1.09-2.91]), Medicaid coverage (AOR = 1.73 [1.20-2.47]), Latina ethnicity (AOR = 1.47 [1.02-2.14]), and non-English language (AOR = 1.72 [1.16-2.55]).

CONCLUSIONS:

Despite an apparent decline in short stays after legislation, many newborns--particularly from lower-income families--continue to be discharged early. Most newborns discharged early--particularly those with Medicaid and those from low-income, Latina, and non-English-speaking homes--do not receive recommended follow-up. The most socioeconomically vulnerable newborns are receiving fewer postnatal services.

PMID:
12563065
[Indexed for MEDLINE]
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