Protocols for early discharging of premature infants: an empirical assessment on safety and savings

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Chiara Daicampi1, Rosanna I Comoretto2, Nicola Soriani2

  • 1Department of Women's and Children's Health, University of Padova, Padova, Italy.

Journal of Perinatal Medicine
|August 18, 2019
PubMed

Insights

Evaluating early discharge criteria for preterm newborns reveals a trade-off between saving hospital days and ensuring infant safety. Some criteria reduce infections and costs but may miss post-discharge apnea and bradycardia episodes.

Area of Science:

  • Neonatal Medicine
  • Health Economics
  • Pediatric Care

Background:

  • Preterm newborns can be discharged when clinically stable.
  • Multiple criteria for early discharge exist.
  • Quantitative comparison of these criteria is lacking.

Purpose of the Study:

  • To quantitatively compare the impact of seventeen early discharge criteria.
  • To assess hospitalization savings, safety, and costs associated with each criterion.

Main Methods:

  • Retrospective analysis of clinical histories from 213 preterm infants.
  • Application of 17 literature-derived early discharge criteria.
  • Computation of hospitalization savings, safety, and costs for each criterion.

Main Results:

  • Average savings ranged from 1.1 to 10.3 hospital days per infant.
  • Fewer infections (0.3-1.1 per infant) were observed with certain criteria.
  • All criteria showed post-discharge apnea/bradycardia episodes (0.3-1.4 mean).
  • Criteria saving more days demonstrated higher cost-effectiveness and infection reduction.

Conclusions:

  • A clear trade-off exists between saved hospital days and infant health risks.
  • Early discharge criteria impact health care costs.
  • Careful consideration of criteria is needed to balance benefits and risks.

Keywords:
cost-effectivenesscriteria for dischargeearly discharge infantssafety

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