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Arch Pediatr Adolesc Med. 2003 Jun;157(6):579-83.

Newborn length of stay, health care utilization, and the effect of Minnesota legislation.

Author information

1
Ramsey Family and Community Medicine Residency Program, 864 Arcade Street, St Paul, MN 55106, USA. madlo001@tc.umn.edu

Abstract

OBJECTIVE:

To describe newborn length of stay, postdischarge follow-up, and health care utilization in the context of Minnesota's early discharge legislation.

DESIGN AND SETTING:

Retrospective study using claims data from a large managed care organization.

PARTICIPANTS:

Term newborns born from January 1995 through February 1999 (N = 22 944).

OUTCOME MEASURES:

Newborn length of stay, home or clinic visits within 1 week of discharge (early follow-up), immunizations completed by age 3 months, readmissions within 1 month of discharge, and urgent care or emergency department visits within 2 months of discharge.

RESULTS:

After enactment of Minnesota's early discharge legislation in 1996, the percentage of newborns with short stays (0-1 days after vaginal birth or 2-3 days after cesarean birth) decreased from 52% to 16% for vaginally born infants and from 87% to 63% for cesarean-born infants (P =.001). Although the legislation mandated coverage for home visits after short stays, only 12.4% of short-stay newborns had early home visits. Overall, 50% of infants had early home or clinic follow-up; compared with those who did not receive early follow-up, these infants were more likely to have complete immunizations (adjusted odds ratio [OR], 1.09; 95% confidence interval [CI], 1.03-1.14), urgent care or emergency department visits (adjusted OR, 1.22; 95% CI, 1.07-1.39), and readmissions (adjusted OR, 2.49; 95% CI, 2.02-3.08).

CONCLUSIONS:

Although implementation of Minnesota's early discharge legislation corresponded with significantly increased lengths of stay, very few short-stay infants received the postdischarge care for which coverage was mandated. Our findings indicate, however, that infants at higher risk for adverse outcomes were appropriately identified to receive early follow-up.

PMID:
12796239
DOI:
10.1001/archpedi.157.6.579
[Indexed for MEDLINE]

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