Causes of Later Discharge in Newborns: A Cost-Benefit Analysis

Introduction: Early postnatal discharge promotes family bonding and reduces hospitalization care and costs. In healthy newborns, later discharge is caused by hyperbilirubinemia, weight loss or feeding difficulties. In other cases, this later discharge could be avoided. Aim: This study was conduc...

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Autores principales:	Raquel Gonçalves, Teresa Botelho, Ana Rodrigues Silva, Joaquim Tiago
Formato:	article
Lenguaje:	EN PT
Publicado:	Sociedade Portuguesa de Pediatria 2021
Materias:	Pediatrics RJ1-570 Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/e687b90383ab456eb23dc6770b7e2353
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spelling	oai:doaj.org-article:e687b90383ab456eb23dc6770b7e23532021-11-04T15:21:25ZCauses of Later Discharge in Newborns: A Cost-Benefit Analysis2184-33332184-4453https://doaj.org/article/e687b90383ab456eb23dc6770b7e23532021-11-01T00:00:00Zhttps://pjp.spp.pt/article/view/21320https://doaj.org/toc/2184-3333https://doaj.org/toc/2184-4453 Introduction: Early postnatal discharge promotes family bonding and reduces hospitalization care and costs. In healthy newborns, later discharge is caused by hyperbilirubinemia, weight loss or feeding difficulties. In other cases, this later discharge could be avoided. Aim: This study was conducted to assess later discharge causes’ and cost-effectiveness in healthy newborns hospitalized in a tertiary neonatal care service. Methods: Retrospective study (January – September 2019). Study group: healthy newborns transferred with their mothers to the postnatal ward of a maternity. All neonates discharged later than three days were included. Newborns admitted to neonatal intensive care unit were excluded. Results: 446 newborns, 55.2% male gender, median gestational age 39 weeks (34 – 41 weeks), median birth weight 3128 grams (1950 – 4475 grams). Median length of stay was four days (4 – 16 days). Main causes of later discharge: weight loss n = 183 (38.2%) and hyperbilirubinemia n = 130 (27.1%). Those both causes were cumulative responsible for 65.3% of the later discharge causes. A statistically significant correlation was observed between hypoglycemia and low birth weight (p = 0.026), maternal disease and pre-eclampsia (p = 0.005), social problem and maternal age younger than 23 years (p = 0.000). Later discharge represented a total cumulative of 709 days and 138 964€ of estimated cost. Conclusions: It is imperative to optimize discharge criteria to avoid unnecessary later discharge in healthy neonates. Early post-discharge evaluation at home, provided by primary care services, could help in the improvement of discharge decision. Raquel GonçalvesTeresa BotelhoAna Rodrigues SilvaJoaquim TiagoSociedade Portuguesa de PediatriaarticlePediatricsRJ1-570Medicine (General)R5-920ENPTPortuguese Journal of Pediatrics , Vol 52, Iss 4 (2021)
institution	DOAJ
collection	DOAJ
language	EN PT
topic	Pediatrics RJ1-570 Medicine (General) R5-920
spellingShingle	Pediatrics RJ1-570 Medicine (General) R5-920 Raquel Gonçalves Teresa Botelho Ana Rodrigues Silva Joaquim Tiago Causes of Later Discharge in Newborns: A Cost-Benefit Analysis
description	Introduction: Early postnatal discharge promotes family bonding and reduces hospitalization care and costs. In healthy newborns, later discharge is caused by hyperbilirubinemia, weight loss or feeding difficulties. In other cases, this later discharge could be avoided. Aim: This study was conducted to assess later discharge causes’ and cost-effectiveness in healthy newborns hospitalized in a tertiary neonatal care service. Methods: Retrospective study (January – September 2019). Study group: healthy newborns transferred with their mothers to the postnatal ward of a maternity. All neonates discharged later than three days were included. Newborns admitted to neonatal intensive care unit were excluded. Results: 446 newborns, 55.2% male gender, median gestational age 39 weeks (34 – 41 weeks), median birth weight 3128 grams (1950 – 4475 grams). Median length of stay was four days (4 – 16 days). Main causes of later discharge: weight loss n = 183 (38.2%) and hyperbilirubinemia n = 130 (27.1%). Those both causes were cumulative responsible for 65.3% of the later discharge causes. A statistically significant correlation was observed between hypoglycemia and low birth weight (p = 0.026), maternal disease and pre-eclampsia (p = 0.005), social problem and maternal age younger than 23 years (p = 0.000). Later discharge represented a total cumulative of 709 days and 138 964€ of estimated cost. Conclusions: It is imperative to optimize discharge criteria to avoid unnecessary later discharge in healthy neonates. Early post-discharge evaluation at home, provided by primary care services, could help in the improvement of discharge decision.
format	article
author	Raquel Gonçalves Teresa Botelho Ana Rodrigues Silva Joaquim Tiago
author_facet	Raquel Gonçalves Teresa Botelho Ana Rodrigues Silva Joaquim Tiago
author_sort	Raquel Gonçalves
title	Causes of Later Discharge in Newborns: A Cost-Benefit Analysis
title_short	Causes of Later Discharge in Newborns: A Cost-Benefit Analysis
title_full	Causes of Later Discharge in Newborns: A Cost-Benefit Analysis
title_fullStr	Causes of Later Discharge in Newborns: A Cost-Benefit Analysis
title_full_unstemmed	Causes of Later Discharge in Newborns: A Cost-Benefit Analysis
title_sort	causes of later discharge in newborns: a cost-benefit analysis
publisher	Sociedade Portuguesa de Pediatria
publishDate	2021
url	https://doaj.org/article/e687b90383ab456eb23dc6770b7e2353
work_keys_str_mv	AT raquelgoncalves causesoflaterdischargeinnewbornsacostbenefitanalysis AT teresabotelho causesoflaterdischargeinnewbornsacostbenefitanalysis AT anarodriguessilva causesoflaterdischargeinnewbornsacostbenefitanalysis AT joaquimtiago causesoflaterdischargeinnewbornsacostbenefitanalysis
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Causes of Later Discharge in Newborns: A Cost-Benefit Analysis

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