Early discharge appears safe for Medicaid newborns

CINCINNATI - A reduction in length of stay for newborns insured by Medicaid appears to be a safe practice - if post-discharge care is well-coordinated, according to a Children's Hospital Medical Center of Cincinnati study published in the September 22/29 edition of The Journal of the American Medical Association (JAMA).

"Early discharge of full-term, Medicaid newborns in Ohio has not resulted in an increase in rehospitalization rates in the two week period following their discharge," says neonatologist Uma Kotagal, M.D., director of health policy and clinical effectiveness at Cincinnati Children's and the study's main author.

"In fact, rehospitalizations for Medicaid newborns decreased 23 percent during this period, perhaps because of better post-discharge coordination of care."

The study involved more than 102,000 healthy, full-term neonates born in Ohio from July 1, 1991, to June 15, 1995, to mothers receiving Medicaid. The mean length of stay decreased 27 percent during that period, from 2.2 days in 1991 to 1.6 days in 1995. In 1991, 20 percent of newborns were discharged one day after birth, and 76 percent two days after birth. By 1995, 54 percent of newborns were discharged one day after birth, and 88 percent two days after birth.

Length of stay varied considerably by region. Mean length of stay decreased each year in every region, with southwest Ohio showing the greatest change, a decrease of 43.5 percent.

The percentage of children who received a primary care visit within two weeks of discharge increased in each year of the study, with an overall increase of 117 percent. There also was an increase in the number of newborns who received a home health visit within 14 days of discharge.

Most rehospitalizations were due to jaundice. Other diagnoses associated with rehospitalization included respiratory problems, fever, infections, digestive disorders, bronchioli

Contact: Jim Feuer
Cincinnati Children's Hospital Medical Center

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