Infant mortality and early postpartum discharge

Malkin, Jesse D.

doi:10.1016/s0029-7844(00)00894-2

Cited by 45 publications

(29 citation statements)

References 14 publications

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“…We chose this outcome because it is clinically important, it can be estimated using administrative data, and a previous study found a medically and statistically significant association between postpartum LOS and infant mortality. 12 We assessed nonmedical costs and health benefits other than reduced mortality qualitatively (see Discussion section).…”

Section: Methodsmentioning

confidence: 99%

“…These data were used in an earlier study that found a significant association between early discharge and infant mortality. 12 The Birth Event Record Database contains linked birth certificates, hospital discharge records, and death certificates for 126 370 newborns accounting for 84% of births in Washington State during 1989 and 1990. Approximately two thirds of the unrepresented births occurred at military hospitals or in homes; the remainder were multiple births (n ϭ 1067), newborns under 2500 g of birth weight (n ϭ 6120), and cases with extensive missing data (n ϭ 32).…”

Section: Effects On Infant Mortalitymentioning

confidence: 99%

“…The dependent variable equals 1 if the newborn died during the neonatal period (the first 28 days of life), during which time the association between early postpartum discharge and infant mortality is strongest. 12 The explanatory variable of primary interest was LOS in hours.…”

Section: Estimation Strategymentioning

confidence: 99%

“…More recently, a third study, based on more data, found a substantial and statistically significant association between early discharge and mortality among Washington State newborns (odds ratio: 3.65 for early versus late discharge; 95% CI: 1.56 -8.54). 12 After the postpartum laws were enacted, the mean postpartum stay in the United States increased from 2.8 days to 3.1 days, according to data from the Health care Utilization Project Nationwide Inpatient Sample. Two studies of costs concluded that increasing postpartum LOS is associated with additional hospital costs of $20 to $23 per hour (in 2000 dollars).…”

mentioning

confidence: 99%

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Postpartum Length of Stay and Newborn Health: A Cost-Effectiveness Analysis

et al. 2003

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ABSTRACT. Objective. To evaluate the cost-effectiveness of increasing lengths of brief postpartum hospitalizations.Methods. A cost-effectiveness model extrapolating from secondary data was used. Social costs in 2000 US dollars were estimated using several sources, including a randomized controlled trial, a retrospective study, and survey data. Life-years saved from reduced infant mortality were estimated from administrative data from Washington State. A total of 113 147 singleton newborns who were born in nonmilitary hospitals in Washington State in 1989 or 1990 and had postpartum stays short enough to be affected by length of stay legislation were studied. The cost-effectiveness of increases in postpartum lengths of stay similar to those that would occur if all mothers and singleton newborns used at least the time allotted to them under the federal length of stay legislation was measured.Results. Estimated lower-bound cost per newborn life-year saved was $19 800 (95% confidence interval: $11 600 -$61 300) when only neonatal deaths were considered. The corresponding upper-bound estimate was $94 800 (95% confidence interval: $55 200 -$286 800). The results were very sensitive to assumptions about the discount rate for future life-years and the time from birth during which averted deaths are considered (neonatal deaths, postneonatal infant deaths, or all infant deaths).Conclusions. At hospitals that do not experience additional capacity costs as a result of increased lengths of stay, lengthening short postpartum stays seems to be more cost-effective than many common health interventions and well below cost-effectiveness thresholds suggested by the literature. Even at hospitals that experience additional capacity costs, the cost-effectiveness of lengthening short postpartum stays seems to be roughly equal to the benchmark of $100 000 per quality-adjusted life-year suggested by the literature. Pediatrics 2003;111:e316 -e322. URL: http://www.pediatrics.org/cgi/content/full/111/4/e316; postpartum, length of stay, newborn, mortality, cost.

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Section: Methodsmentioning

confidence: 99%

Section: Effects On Infant Mortalitymentioning

confidence: 99%

Section: Estimation Strategymentioning

confidence: 99%

mentioning

confidence: 99%

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Postpartum Length of Stay and Newborn Health: A Cost-Effectiveness Analysis

et al. 2003

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“…Dünya Sağlık Örgütü (DSÖ) ise anne ve yenidoğanın hastane enfeksiyonlarından korunabilmesi için en erken dönemde taburcu edilmeleri gerektiğini bildirmiştir (1). Normal doğumdan 12-48 saat sonra taburcu olunmasını uygun bir süre olarak gören çalışmalar da bulunmaktadır (6)(7)(8)(9)(10)(11)(12).…”

Section: Introductionunclassified

Postpartum discharge readiness situation of women who had vaginal deliveries

Dağ¹,

Dönmez²,

Şen³

et al. 2013

Gaziantep Med J

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ÖzetBu araştırma vajinal doğum yapmış, postpartum dönemde olan kadınların hastaneden taburculuğa hazır oluşluklarının değerlendirilmesi amacıyla tanımlayıcı ve kesitsel tipte planlanmıştır. Araştırma, 01.03.2012-01.04.2012 tarihleri arasında bir devlet hastanesinde vajinal doğum yapmış 110 kadına uygulanmıştır. Veri toplama aracı olarak birey tanılama formu ve Hastane Taburculuğuna Hazır Oluşluk Ölçeği-Yeni Doğum Yapmış Anne Formu (HTHÖ-YDAF) kullanılmıştır. Katılımcıların yaş ortalaması 25.30± 5.32 olup %38.2'si ilkokul mezunu ve %51.8'i en uzun süre yaşadığı yer olarak il saptanmıştır. Annelerin %66.4'ü taburculukla ilgili bilgi almamış olup bilgi alanların %31.8'i hemşire ve öğrenci hemşirelerden almıştır. Annelere taburcu olmadan önce en fazla bilgi verilen ilk üç konu arasında %47.3 bebeğin gazının çıkartılması, %46.4 bebeğin alt temizliği, %40.9 bebeğin göbek bakımı olarak belirlenirken, en az bilgi verilen konu ise %87.3 lohusalık egzersizleri olarak belirlenmiştir. Annelerin %41.8'si bebek bakımı konusunda kendilerine en çok yardım eden kişinin kayınvalidesini olduğunu belirtmiştir. Katılımcıların %74.5'i taburculuğa kendini hazır hissettiğini belirtmiştir. HTHÖ-YDAF'nin puan ortalaması 142.09±43.76 olup ölçeğin alt boyutlarının sırasıyla puan ortalamaları: kişisel durum 52.56±12.82, bilgi durumu 44.63±17.97, yetenek durumu 19.04±7.75, beklenen destek 25.85±11.15 olarak saptanmıştır. Çalışmamızın sonuçlarına göre annelerin yarısından fazlası kendini taburculuğa hazır hissetmesine rağmen ölçek puanlarına göre taburculuğa orta düzeyde hazır oldukları, yetenek ve beklenen destek alt boyutlarından düşük puan aldıkları belirlenmiştir. Sağlık personeli tarafından annelere taburculuk eğitiminde daha kapsamlı bilgi verilmelidir. Anahtar kelimeler: Doğum sonrası bakım; eğitim; taburculuk. AbstractThis research was planned to evaluate postpartum discharge readiness situation of women who had vaginal deliveries at hospital as being a descriptive, cross sectional study. This research was made in a state hospital between 01.03.2012-01.04.2012 to 110 women who had vaginal deliveries. In data collection, individual data collection form, Readiness for Hospital Discharge Scale-New Mother Form (RHD-NMF) was used. The average age of participants was 25.30±5.32 and 38.2% of them have primary school education and 51.8% of them lived in the province the longest. 66.4% of mother's did not receive any information about discharge and 31.8% of them took it from nurses and nursing students. The first three mostly information given subjects to mothers before discharge are 47.3% baby's gas extraction, 46.4% perineal cleaning of the baby, 40.9% umbilical cord care and least information given subject is 87.3% postpartum exercises. 41.8% of the mothers stated that who helped them the most in the baby care is mothers in laws. 74.5% of the participants stated that they feel ready themselves for hospital discharge. The mean score of RHD-NMF was 142.09±43.76, respectively the mean scores of subscales are: personal status 52.56±12.82, knowl...

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Early postnatal discharge from hospital for healthy mothers and term infants

Jones

Stewart

Taylor

et al. 2021

Cochrane Database of Systematic Reviews

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Infant mortality and early postpartum discharge

Abstract: Newborns discharged within 30 hours of birth are at increased risk of death within the first year of life.

Cited by 45 publications

References 14 publications

Postpartum Length of Stay and Newborn Health: A Cost-Effectiveness Analysis

Postpartum Length of Stay and Newborn Health: A Cost-Effectiveness Analysis

Postpartum discharge readiness situation of women who had vaginal deliveries

Early postnatal discharge from hospital for healthy mothers and term infants

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