"In the decade before these laws, postpartum hospital stays were getting shorter and shorter, possibly because more people were covered by managed-care organizations that were trying to cut costs," said Dr. William H. Dow, assistant professor of health policy and administration at the UNC School of Public Health. "Women were leaving hospitals less than 24 hours after vaginal deliveries.
"Starting in 1995, negative press reports began featuring so-called 'drive-through deliveries,' including stories about children who had died or had other bad outcomes maybe as a result," Dow said. "State and federal governments began debating length-of-stay mandates in response to these news reports and pressure from women's advocates." In 1995, Maryland became the first of many states to regulate the length of hospital stays after birth. In 1998, a similar federal law took effect that filled gaps in state drive-through delivery regulation efforts. Those laws generally required that most health insurance plans pay for at least a 48-hour stay after vaginal delivery and a 96-hour stay following cesarean delivery.
A report on the impacts of the laws appears in the current issue of the Journal of Health Economics. Besides Dow, study collaborators include Dr. Zhimei Liu, a former doctoral student at UNC now with Zynx Inc. in Los Angeles, a private health research group; and Dr. Edward C. Norton and Dean M. Morris, associate professor and clinical associate professor, respectively, of health policy and administration.
Using a national hospital discharge database and focusing on 18 states and a million hospital records, the researchers sought to
Contact: David Williamson
University of North Carolina at Chapel Hill