Health service use among low-risk newborns after early discharge with and without nurse home visiting

J Am Board Fam Pract. Jul-Aug 1996;9(4):254-60.

Abstract

Background: To examine the potential benefits of routine nurse home visiting after early discharge, we compared health service use among low-risk newborns with and without a nurse home visit and telephone follow-up after short hospital stays.

Methods: Records of newborns discharged routinely before (n = 83) and after (n = 91) implementation of a universal postpartum home visiting program were reviewed retrospectively. Acute care visits, rehospitalizations, and well-baby visits for newborns up to 74 days of age were compared between the groups.

Results: Acute care visits, rehospitalizations, and missed well-baby visits consistently appeared less likely among newborns receiving home visiting services, in both unadjusted and adjusted analyses. Adjusting for insurance, parity, and breast-feeding, a twofold reduction in acute care visits by 14 days was significant. Although not statistically significant, adjusted analyses of acute care and missed well-baby visits revealed apparently similar patterns at all time intervals. There were too few rehospitalizations for multivariate analysis.

Conclusions: Despite the limitations of this small retrospective study, the consistency of the findings suggests potentially important benefits of home visiting services after early discharge of low-risk newborns, with substantial implications for clinical and reimbursement policy. Effects could be greater with more vulnerable populations and shorter stays than those in this study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Confidence Intervals
  • Home Care Services / economics
  • Home Care Services / statistics & numerical data*
  • Humans
  • Infant, Newborn
  • Insurance, Health / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Multivariate Analysis
  • Neonatal Nursing / economics
  • Neonatal Nursing / methods*
  • Odds Ratio
  • Office Visits / economics
  • Office Visits / statistics & numerical data
  • Outcome and Process Assessment, Health Care / statistics & numerical data*
  • Patient Compliance
  • Patient Readmission / statistics & numerical data
  • Retrospective Studies
  • San Francisco