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Post-maternity outcomes following health care reform in Alberta: 1992-1996
Angus H Thompson1, Arif Alibhai, L Duncan Saunders
1Alberta Centre for Injury Control & Research and the Department of Psychiatry, University of Alberta, Edmonton, AB. gus.thompson@ualberta.ca
Objective:
The effect of Alberta's health reform on length of stay for maternity cases and on subsequent mothers' rehospitalization was examined in the present study.
Methods:
The data set included all Alberta acute care hospital separation records from 1991/92 to 1996/97 inclusive. A logistic regression was applied to the data in order to examine the effects of prepartum condition, type of delivery, length of stay, maternal age, and year on the likelihood of readmission.
Results:
Health reform proved to be associated with a dramatic decrease in length of stay for maternity cases; from 3.8 to 2.4 days on average. This was accompanied by very little variation in the 90-day readmission rate for mothers over the same time period (notably, a slight decrease). Higher readmission rates were associated with the existence of difficulties during the pregnancy and other prenatal conditions, maternal age, and with the type of delivery. There were no dramatic changes in the rates for prepartum diagnoses, nor for the type of delivery.
Discussion:
The data suggest that the reduction in the length of maternity stay has had no discernible negative health effects on new mothers, perhaps because of the home visiting programs that were put in place. Furthermore, there may still be room to improve outcomes by focussing on those with prepartum conditions and cases involving complicated births.