Safety of Early Newborn Discharge for Medicaid Infants in One Ohio County• 1282

Earlier discharge of newborns (NB) has become common, but the safety of this practice requires verification for potentially higher risk Medicaid patients. We evaluated the effect of earlier discharge on readmission rates(REA) for Ohio Medicaid patients born in one county. Methods: Using linked birth certificate/Medicaid claims data sets for Ohio from 7/91-6/95, two groups defined; healthy term newborns (HTNB) and live discharge <2,000 grams preterm newborns (PTNB). For HTNB, short stay defined as ≤1 day for vaginal, and ≤2 days for C-sections. Lengths of stay (LOS) and REA within 7 and 14 days calculated. Statistics: Descriptive, Chi² Trend, logistic regression. Results: By calendar year. For all Medicaid newborns, there was a significant decrease in LOS (p<0.001) and an associated decrease in REA at 7, 14 days (p<.05). For HTNB there was reduction in LOS (p<.001), and associated trend towards decrease in REA rates at 7 days (p<.08), 14 days (p<.05). On multi-variate analysis maternal age and gestation were predictors of REA at 7 & 14 days. There was an impact of year of birth with declining REA at 7 days (OR.79, p<.05), but not at 14 days. The significant decrease in LOS for PTNB (p<0.05) was associated with no change in REA rates (p=n.s). Conclusions: Using readmission rates as a measure, these results provide no evidence that earlier discharge affects outcomes adversely for Medicaid insured newborns. Table

Table 1 No caption available.

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