Effects Of Maternity-Stay Legislation On ‘Drive-Through Deliveries’

Udom, Nduka U.; Betley, Charles

doi:10.1377/hlthaff.17.5.208

Cited by 28 publications

(24 citation statements)

References 1 publication

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“…These results are consistent with previous research that has also examined the LOS effects of postpartum legislation in other states. 6,9,11,[18][19][20] The current study adds to this literature by examining how the effects of the postpartum legislation on LOS varied with demographics, delivery type, and deliveryand pregnancy-related complications. It is important to examine these differential effects to evaluate whether the legislation had a greater impact on LOS for infants who were at greater risk of adverse outcomes because of early discharge.…”

Section: Discussionmentioning

confidence: 99%

Impact of Postpartum Hospital-Stay Legislation on Newborn Length of Stay, Readmission, and Mortality in California

Datar

Sood

2006

Pediatrics

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OBJECTIVES. The objectives of this study were to examine the impact of postpartum hospital-stay legislation on newborns' length of stay, neonatal readmissions, and 1-year mortality in California, and whether this legislation had differential impacts by demographics and complications during delivery or pregnancy.METHODOLOGY. This study used linked birth certificates, death certificates and hospital discharge records for all full-term, normal birth weight, and singleton-birth newborns during 1991-2000 in California (n ϭ 662 753). Interrupted time-series analyses were used to examine changes in newborns' length of stay and outcomes after 1 year, 2 years, and 3 years since the passage of postpartum laws. Multivariate linear and logistic regressions were estimated separately by maternal characteristics (race, education, age, and partity), delivery type, and complications during pregnancy or delivery.RESULTS. Length of stay increased by 9.5, 12, and 14 hours in years 1, 2, and 3, respectively, after the passage of the law. Increases were larger for newborns of white mothers, more educated mothers, mothers Ͼ35 years of age, primaparous mothers, cesarean deliveries, and Medicaid recipients, but there were no differences by pregnancy or delivery complications. The odds of neonatal readmission declined by 9.3%, 11.8%, and 19.7% in years 1, 2 and 3 after the law, respectively. The odds of infection-related readmissions declined by 21.5% and 30.3% in years 2 and 3, respectively. The odds of jaundice-related readmissions increased by 7% in year 1. There was no significant change in either the odds of readmission due to respiratory problems or the odds of 1-year mortality in the postlaw years. Demographic differences in the impact of the law on readmissions and mortality could not be detected because of lack of statistical power.CONCLUSIONS. Postpartum length of stay legislation was associated with increased length of stay among all births in California, with significant variation in the law's impact across demographic groups. After the law's passage, there was a significant decline in neonatal readmissions but not in 1-year mortality.www.pediatrics.org/cgi

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Section: Discussionmentioning

confidence: 99%

Impact of Postpartum Hospital-Stay Legislation on Newborn Length of Stay, Readmission, and Mortality in California

Datar

Sood

2006

Pediatrics

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“…To calculate the lower-and upper-bound cost estimates, we relied on data from surveys, 15,16 a randomized controlled trial, 17 and administrative records. 6,13,18 All costs were expressed in 2000 US dollars using the medical care component of the Consumer Price Index. We did not discount costs because almost all costs attributable to increased postpartum LOS are incurred within the first few weeks after birth.…”

Section: Costsmentioning

confidence: 99%

“…Two studies of costs concluded that increasing postpartum LOS is associated with additional hospital costs of $20 to $23 per hour (in 2000 dollars). 13,14 Thus, according to these studies, extending the average postpartum stay by 12 hours would cost a hospital between $240 and $276 per birth. These estimates seem to be too high for hospitals where longer stays do not affect hospital capacity.…”

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confidence: 99%

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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“…Against this background, this paper attempts to identify risk factors for short-stay, medium-stay and long-stay subgroups of patients, and analyzes LOS as an indicator of the pressure on inpatient treatment, with a view to enhancing standardization of the curative healthcare delivery system in India. From both the physical and mental health perspectives of patients, the shorter the recovery time (in terms of shorter LOS), the more effective is the curative treatment [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Inpatient length of stay: a finite mixture modeling analysis

Chungkham

Ladusingh

2009

Eur J Health Econ

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Length of stay (LOS) in hospital for inpatient treatment is a measure of crucial recovery time. Using nationwide data on inpatient healthcare in India, a three-component finite mixture negative binomial model was found to provide a reasonable fit to the heterogeneous LOS distribution. Associated risk factors for short-stay, medium-stay and long-stay subgroups were identified from the respective negative binomial components. In addition, significant heterogeneities within each group were also found.

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Effects Of Maternity-Stay Legislation On ‘Drive-Through Deliveries’

Cited by 28 publications

References 1 publication

Impact of Postpartum Hospital-Stay Legislation on Newborn Length of Stay, Readmission, and Mortality in California

Impact of Postpartum Hospital-Stay Legislation on Newborn Length of Stay, Readmission, and Mortality in California

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

Inpatient length of stay: a finite mixture modeling analysis

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