Maternal Postpartum Health Care Utilization and the Effect of Minnesota Early Discharge Legislation

Abstract

Purpose: To describe maternal postdischarge follow-up and health care utilization in the context of Minnesota's early discharge legislation, which mandates coverage for a home visit for a mother and baby who voluntarily leave the hospital early.Methods: Claims data from a large managed care organization were used to identify 22,944 women giving birth from January 1995 through February 1999. Study variables included home or clinic visits within 1 week of discharge (early follow-up), readmissions within 1 month of discharge, and urgent care or emergency department visits within 2 months of discharge.Results: After enactment of Minnesota's legislation, the percentage of mothers with short stays decreased from 52% to 16% for vaginal births and from 87% to 63% for cesarean births (P ‫؍‬ .001). Overall, 33% of mothers with vaginal births and 40% with cesarean births had early home or clinic follow-up (P ‫؍‬ .001). Mothers who stayed 0 or 1 hospital days after vaginal births were more likely to have early follow-up than those with longer stays (37% vs 32%, P ‫؍‬ .01). However, mothers who stayed 2 or 3 days after cesarean birth were no more likely to have early follow-up than mothers who stayed 4 or more days (39% vs 42%, P ‫؍‬ .08). Rates of early follow-up were significantly higher after enactment of Minnesota's legislation, regardless of length of stay.Conclusions: Implementation of Minnesota's early discharge legislation corresponded with significantly increased lengths of stay and an increase in the percentage of mothers who received early follow-up visits. However the majority of mothers with short stays continued to lack early follow-up.

Use of early postnatal care among postpartum women in Eastern Uganda

“…This finding contradicts results from other studies [21]; EPNC utilization was driven by postpartum complications in the present study whereas a study in Palestine indicated that EPNC was driven by the number of prenatal care visits and maternal knowledge of postnatal care [16]. Additionally, a prolonged stay in hospital was perceived to reflect perfect health at the time of discharge, and therefore promoted disregard for EPNC.…”

Postpartum discharge readiness situation of women who had vaginal deliveries

“…Erken taburculuk, herhangi bir komplikasyonun olmadığı durumlarda kadınların vajinal doğumdan 48 saat sonra, sezaryan doğumdan 96 saat sonra taburcu edilmesi olarak tanımlanırken, vajinal doğumdan sonra 24 saat içinde taburcu edilme ise 'çok erken taburculuk' olarak belirtilmiştir (6)(7)(8). Dünya Sağlık Örgütü (DSÖ) ise anne ve yenidoğanın hastane enfeksiyonlarından korunabilmesi için en erken dönemde taburcu edilmeleri gerektiğini bildirmiştir (1).…”

“…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).…”

Early hospital discharge and early puerperal complications

“…Las variables relacionadas con egreso temprano en el análisis bivariado (con p<0. 15) fueron incluidas en un modelo de regresión logística. Resultados.…”

“…[1][2][3][4][5][6][7][8][9] Hospital length of stay after childbirth has decreased progressively during the past 60 years. [10][11][12][13][14][15] In the early 1980s in Mexico, the Mexican Social Security Institute (Instituto Mexicano del Seguro Social -IMSS) developed the program Atención de Parto de Bajo Riesgo (Care for Low-Risk Delivery), 16,17 which resulted in a six-hour reduction in postpartum hospital stays.…”