The effects of newborn early discharge on hospital readmissions

The objective of this study is to determine the effects of early newborn hospital discharge policy on hospital readmission for Medicaid infants. It is a multiple year, retrospective study in which early hospital discharges were followed using Medicaid claims data to determine the rate of readmissions for newborns during 1989-1992, the years in which this policy became widespread in Maryland. Analysis compares early discharges, using chi 2 tests, and calculates odds ratios to estimate the risk of readmissions. Our results found significant increases in early discharges for Medicaid newborns over time among sick newborns. The odds of readmissions for normal babies discharged early were about the same as for those kept longer, but for sick babies discharged early they were significantly greater, especially during the early study years. Findings from this natural experiment indicate that early discharge of Medicaid newborns with physical problems increases their likelihood of readmissions. Careful attention to the needs of these higher risk infants must be a part of any hospital or managed care program implementing early discharge policy.