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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2003 Mar 1;94(2):104–108. doi: 10.1007/BF03404581

Post-maternity Outcomes Following Health Care Reform in Alberta: 1992–1996

Angus H Thompson 15,, Arif Alibhai 25, L Duncan Saunders 25, David C Cumming 35, Narmatha Thanigasalam 25
PMCID: PMC6980220  PMID: 12675165

Abstract

Objective: The effect of Alberta’s health reform on length of stay for maternity cases and on subsequent mothers’ rehospitalization was examined in the present study.

Methods: The data set included all Alberta acute care hospital separation records from 1991/92 to 1996/97 inclusive. A logistic regression was applied to the data in order to examine the effects of prepartum condition, type of delivery, length of stay, maternal age, and year on the likelihood of readmission.

Results: Health reform proved to be associated with a dramatic decrease in length of stay for maternity cases; from 3.8 to 2.4 days on average. This was accompanied by very little variation in the 90-day readmission rate for mothers over the same time period (notably, a slight decrease). Higher readmission rates were associated with the existence of difficulties during the pregnancy and other prenatal conditions, maternal age, and with the type of delivery. There were no dramatic changes in the rates for prepartum diagnoses, nor for the type of delivery.

Discussion: The data suggest that the reduction in the length of maternity stay has had no discernible negative health effects on new mothers, perhaps because of the home visiting programs that were put in place. Furthermore, there may still be room to improve outcomes by focussing on those with prepartum conditions and cases involving complicated births.

References

  • 1.Wen SW, Liu S, Marcoux S, Fowler D. Trends and variations in length of hospital stay for childbirth in Canada. CMAJ. 1998;158:875–80. [PMC free article] [PubMed] [Google Scholar]
  • 2.Britton JR, Britton HL, Beebe SA. Early discharge of the term newborn: A continued dilemma. Pediatrics. 1994;94:291–95. [PubMed] [Google Scholar]
  • 3.Braveman P, Egerter S, Pearl M, Marchi K, Miller C. Early discharge of newborns and mothers: A critical review of the literature. Pediatrics. 1995;96:716–26. [PubMed] [Google Scholar]
  • 4.Lee KS, Perlman M, Ballantyne M, Elliott I, To T. Association between duration of neonatal hospital stay and readmission rate. J Pediatrics. 1995;127:758–67. doi: 10.1016/S0022-3476(95)70170-2. [DOI] [PubMed] [Google Scholar]
  • 5.Liu S, Wen SW, McMillan D, Trouton K, Fowler D, McCourt C. Increased neonatal readmission rate associated with decreased length of hospital stay at birth in Canada. Can J Public Health. 2000;91:46–50. doi: 10.1007/BF03404253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.Lock M, Ray JG. Higher neonatal morbidity after routine early hospital discharge: Are we sending newborns home too early? CMAJ. 1999;161:249–53. [PMC free article] [PubMed] [Google Scholar]
  • 7.Liu LL, Clemens CJ, Shay DK, Davis RL, Novack AH. The safety of newborn early discharge: The Washington State experience. JAMA. 1997;278:293–98. doi: 10.1001/jama.1997.03550040049036. [DOI] [PubMed] [Google Scholar]
  • 8.Taniguchi H. Early discharge: Its impact on lowincome mothers and newborns in the state of Hawaii. J Obstet Gynaecol Res. 1999;25:185–91. doi: 10.1111/j.1447-0756.1999.tb01145.x. [DOI] [PubMed] [Google Scholar]
  • 9.Malkin JD, Broder MS, Keeler E. Do longer postpartum stays reduce newborn readmissions? Analysis using instrumental variables. Health Serv Res. 2000;35:1071–91. [PMC free article] [PubMed] [Google Scholar]
  • 10.Edmonson BM, Stoddard JJ, Owens LM. Hospital readmission with feeding-related problems after early postpartum discharge of normal newborns. JAMA. 1997;278:299–303. doi: 10.1001/jama.1997.03550040055037. [DOI] [PubMed] [Google Scholar]
  • 11.Darj E, Stalnacke B. Very early discharge from hospital after normal deliveries. Ups J Med Sci. 2000;105:57–66. doi: 10.1517/03009734000000047. [DOI] [PubMed] [Google Scholar]
  • 12.Lydon-Rochelle M, Holt VL, Martin DP, Easterling TR. Association between method of delivery and maternal rehospitalization. JAMA. 2000;283:2411–16. doi: 10.1001/jama.283.18.2411. [DOI] [PubMed] [Google Scholar]
  • 13.Bossert R, Rayburn WF, Stanley JR, Coleman F, Mirabile CR., Jr Early postpartum discharge at a university hospital: Outcome analysis. J Reprod Med. 2001;46:39–43. [PubMed] [Google Scholar]
  • 14.Lane DA, Kauls LS, Ickovics JR, Naftolin F, Feinstein AR. Early postpartum discharges. Impact on distress and outpatient problems. Arch Fam Med. 1999;8:237–42. doi: 10.1001/archfami.8.3.237. [DOI] [PubMed] [Google Scholar]
  • 15.Regional Health Authorities Act. Statutes of Alberta. Edmonton: Queen’s Printer; 1994. [Google Scholar]
  • 16.Alberta HealthWellness. Alberta reproductive health: Pregnancy outcomes 1999. Edmonton: Alberta Health & Wellness/Alberta Medical Association; 2000. [Google Scholar]
  • 17.International Classification of Diseases . Ninth revision. Clinical Modification. Washington, DC: Public Health Services, US Dept of Health and Human Services; 1988. [Google Scholar]
  • 18.Grimes DA. The morbidity and mortality of pregnancy: Still risky business. Am J Obstet Gynecol. 1994;170:1489–94. doi: 10.1016/s0002-9378(94)05009-x. [DOI] [PubMed] [Google Scholar]
  • 19.Alberta HealthWellness. Reproductive health: Pregnancy outcomes Alberta, 1985/86–1995/96. Edmonton: Alberta Health & Wellness; 1997. [Google Scholar]

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