The 130th Annual Meeting of APHA

Abstract #45255

Mary Kelly, Dr P H, Health Services Administration, University of Detroit Mercy, P. O. Box 19900, Detroit, MI 48219, (313) 964-4182, kellyml@udmercy.edu

Factors predicting hospital readmission of normal newborns

Objective: to identify factors predicting unplanned hospital readmission of normal newborns within 28 days of birth. Design: cohort study using a retrospective sample of administrative records; 29,475 babies were followed for 28 days to see which babies were readmitted to hospitals. Setting: 12 member hospitals of a non-profit health system from two Midwestern states Patients: Administrative records of all normal newborns (DRG 391) born from July 1997 to December 1999 (n=31315) whose records could be matched with maternal records and SES data (n=29,475). Main Outcome Measures: hospital readmission within 28 days of birth for (1) all diagnoses, (2) jaundice, and (3) infection. Results: (1) Male gender, vaginal delivery, December birth, jaundice in the nursery, treatment with phototherapy in the nursery, younger maternal age, premature rupture of membranes, and site of birth were predictors of readmission for all diagnoses within 28 days of birth. (2) Male gender, vaginal delivery, December birth, jaundice in the nursery, treatment with phototherapy in the nursery, maternal complications, premature rupture of membranes, and site of birth were predictors of readmission for jaundice within 28 days of birth. (3) Only birth in a winter month, younger maternal age and site of birth were predictors of readmission for infection within 28 days of birth. Conclusions: The findings suggest that use of the normal newborn risk profile and some simple interventions consistent with the AAP minimum criteria for newborn discharge may reduce hospital readmission of healthy newborns.

Learning Objectives:

• Identify factors that predict unplanned hospital readmission of normal newborns for all diagnoses, for jaundice and for infection.
• Describe areas for further research regarding unplanned hospital readmission of normal newborns.
• Articulate the relationship between AAP guidelines for newborn discharge and factors that predict unplanned hospital readmission of newborns.

Keywords: Maternal and Child Health, Hospitals

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.