Factors associated with early maternal postpartum discharge from the hospital
L. H. Margolis, M. Kotelchuck and H. Y. Chang
Department 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.
