Readmission Rates After Expedited Postpartum Discharge

Area of Science:

• Obstetrics and Gynecology
• Health Services Research
• Public Health

Background:

• Expedited postpartum discharge, defined as less than 2 days after vaginal birth or less than 3 days after cesarean birth, is increasingly utilized.
• Understanding national trends and safety implications of this practice is crucial for maternal healthcare.
• Predictors of expedited discharge and its association with postpartum readmissions require further investigation.

Purpose of the Study:

• To analyze national trends in expedited postpartum discharge from 2016 to 2020.
• To identify clinical, hospital, and demographic factors associated with expedited postpartum discharge.
• To determine if expedited postpartum discharge impacts 60-day postpartum readmission rates.

Main Methods:

• Retrospective cohort study using the 2016-2020 Nationwide Readmissions Database.
• Categorization of postpartum discharge into expedited, routine, and prolonged based on length of stay.
• Joinpoint regression for trend analysis and logistic regression for predictor and readmission risk assessment.

Main Results:

• In 2020, 43.8% of 17.9 million birth hospitalizations utilized expedited postpartum discharge, a significant increase from prior years.
• Expedited postpartum discharge was associated with a 14% lower adjusted odds of 60-day postpartum readmission compared to routine discharge.
• Younger/older age, comorbidities, mental health conditions, and obstetric complications were linked to lower likelihood of expedited discharge.

Conclusions:

• Expedited postpartum discharge rates significantly increased in 2020.
• The rise in expedited postpartum discharge was not linked to an increase in 60-day postpartum readmissions.
• Broader implementation of expedited postpartum discharge appears safe and may be associated with reduced readmission risk.