Impact of discharge timings of healthy newborns on the rates and etiology of neonatal hospital readmissions

ABSTRACT

To evaluate the effect of early hospital discharge after initial birth hospitalization on the rate and etiology of hospital readmission during the neonatal period. Cross-sectional analytical study. King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia, from October 2008 to September 2011. Full-term normal newborns were included in this study, and all infants showing any features that would increase the chances or readmission were excluded. Initial birth hospitalization and readmission in the neonatal period were analyzed. Data was collected from the Discharge Abstract Database. Overall, 12,728 normal newborns were delivered during the study period. Vaginally delivered infants were discharged early [within 48 hours], while those delivered via caesarean section had longer hospital stays [mean length of stay 1.1 and 2.8 days, respectively]. There were 166 readmissions, wherein the leading cause was neonatal sepsis [37.3%] followed by neonatal jaundice [26.5%]. The readmission rate in early discharged [142 out of 9927] was significantly higher [p = 0.017] as compared to newborns who were discharged late after birth [24 out of 2801]. Etiology of readmissions was not affected by discharge timings. Hospital discharge of neonates within 48 hours after delivery is counterproductive and significantly increases the risk for hospital readmission during the neonatal period. The pre-dominance of sepsis related cases observed here indicates the need to explore its causes and determine an optimal prevention and management strategy