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Factors associated with early maternal postpartum discharge from the hospital
L H Margolis1, M Kotelchuck, H Y Chang
1Department of Maternal and Child Health, University of North Carolina, Chapel Hill, USA.
Objective:
To examine if mothers discharged from the hospital after 1 night's stay or less (early discharge) differ from those discharged from the hospital after 2 or 3 nights' stay (regular discharge) in demographic, economic, behavioral, health status, and health services risk factors associated with maternal and infant well-being.
Design:
Bivariate and logistic comparisons of women discharged from the hospital early or after a regular hospitalization as reported in the 1988 National Maternal and Infant Health Survey.
Participants:
Postpartum women.
Main Outcome Measure:
Postpartum discharge from the hospital after 1 night's stay or less in the hospital.
Results:
Early discharge from the hospital occurred for 12.3% of 3,865 366 women. Logistic regression revealed 8 factors that were associated with early discharge from the hospital: less than a high school education, aged older than 35 years, inadequate prenatal care, lack of private insurance or receipt of Medicaid for delivery, giving birth in the western United States, plans to breast-feed, and care by midwives. Two factors were associated with an increased likelihood of a regular discharge from the hospital: report of a hospitalization during pregnancy and giving birth in the Midwest or Northeast.
Conclusions:
Significant numbers of mothers discharged from the hospital early manifested health and social risk factors associated with poor health outcomes. Economic factors seemed an important motivation for early discharge from the hospital, as did inadequate use of health services. Since brief hospitalization is prevalent, clinicians and administrators must assure that the objectives of medical contact during childbirth are met, if not through hospitalization, then through other mechanisms.