Abstract
The Ontario Mother and Infant Survey examined health and social service utilization of postpartum women and newborn infants from five hospital sites. A cross-sectional multi-language survey design with longitudinal follow-up was used: 1,250 eligible, consenting women completed a self-report questionnaire in hospital and 875 women participated in a structured telephone interview at four weeks post-discharge. Rates of newborn infant readmission ranged from 2.4% to 6.7%. The best predictors of readmission were: main source of household income was other than employment; maternal self-rating of health was poor; mother anticipated inadequate help and support at home following discharge; mother received help from friends/neighbours following discharge; and mother had concern about infant care and behaviour. Readmission was not associated with length of postpartum hospital stay. The study findings suggest that there is a complex relationship between infant health care needs, family resources and provider practices that produces clinically important, site-specific readmission patterns.
Résumé
Le Sondage sur la mère et l’enfant en Ontario a examiné, dans cinq hôpitaux, l’utilisation des services sociaux et de santé par les femmes qui venaient d’accoucher et leurs nouveau-nés. Nous nous sommes servis d’un sondage transsectoriel en plusieurs langues avec un suivi longitudinal: 1 250 femmes admissibles ont consenti à remplir soi-même un questionnaire à l’hôpital. De ce groupe, 875 femmes ont participé à une entrevue téléphonique structurée quatre semaines après leur sortie de l’hôpital. Les taux de réadmission des nouveau-nés variaient de 2,4 % à 6,7 %. Les principaux prédicteurs de réadmission étaient les suivants: l’emploi n’était pas la source principale de revenu du foyer; la mère percevait son propre état de santé comme étant médiocre; la mère prévoyait ne pas recevoir d’aide et de soutien adéquats à domicile à sa sortie de l’hôpital; la mère avait reçu l’aide d’amis et de voisins à sa sortie de l’hôpital; ou la mère était préoccupée par le comportement du nouveau-né et les soins à lui donner. La réadmission n’était pas associée à la durée du séjour à l’hôpital après l’accouchement. Les résultats de l’étude font état de liens complexes entre les besoins en soins de santé du nouveau-né, les ressources familiales et les pratiques des intervenants et montrent que ces liens mènent à des modèles de réadmission, propres à chaque hôpital, qui présentent des variantes importantes sur le plan clinique.
Footnotes
This study was funded by the Canadian Health Services Research Foundation and co-sponsored by: Social and Public Health Services, City of Hamilton (Public Health Research, Education and Development Program); the System-Linked Research Unit on Health and Social Service Utilization, McMaster University; and St. Joseph’s Health Care System Research Network
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