Skip to main content
Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 1998 Mar 1;89(2):115–119. doi: 10.1007/BF03404402

Trends and Variations in Neonatal Length of In-hospital Stay in Canada

Shi Wu Wen 1,, Shiliang Liu 1, Dawn Fowler 1
PMCID: PMC6990177  PMID: 9583253

Abstract

Purpose: To analyze spatio-temporal variations of neonatal length of in-hospital stay in Canada.

Method: The length of in-hospital stay of 1,469,761 newborns in Canadian hospitals from April 1, 1984 to March 31, 1995 recorded by the Canadian Institute for Health Information was analyzed.

Results: Neonatal length of in-hospital stay decreased from an average of 5.0 days in 1984 to 2.9 days in 1994. In 1994, the average neonatal length of in-hospital stay in Alberta was 2.5 days, which was 0.2 to 1.5 days shorter than other provinces. The spatio-temporal variations in neonatal length of in-hospital stay could not be explained by corresponding variations in birthweight and other neonatal disorders.

Conclusions: Neonatal length of in-hospital stay has been substantially reduced in Canada in recent years but there remain important interprovincial variations. These variations are unlikely to be the results of changes or differences in patient-specific factors; policy played an important role.

References

  • 1.Parisi VM, Meyer BA. To stay or not to stay? That is the question. New Engl J Med. 1995;333:1635–37. doi: 10.1056/NEJM199512143332412. [DOI] [PubMed] [Google Scholar]
  • 2.Braverman P, Egerter S, Pearl M, et al. Early discharge of newborns and mothers: A critical review of the literature. Pediatrics. 1995;96:716–26. [PubMed] [Google Scholar]
  • 3.Jadad AR, Hillier TLB, Fowler D, Enkin M. Early discharge after delivery: Is it beneficial or harmful “drive through” health care? A systemat-ic review of controlled studies (Unpublished document).
  • 4.Commission on ProfessionalHospital Activities. International Classification of Diseases. Ann Arbor, MI: Commission on Professional and Hospital Activities; 1992. [Google Scholar]
  • 5.Minister of Supply and Services Canada: Canadian classification of diagnostic, therapeutic, and surgical procedures. Ottawa: Minister of Supply and Services Canada, 1986.
  • 6.Cunningham FG, MacDonald PC, Leveno KJ, et al., editors. William’s Obstetrics. 19th ed. Norwalk: Appleton & Lange; 1993. [Google Scholar]
  • 7.Enkin M, Keirse M, Renfrew M, Neilson J, editors. The Cochrane Collaboration: Pregnancy and Childbirth Database. 1994. [Google Scholar]
  • 8.Joseph KS, Kramer MS. Recent trends in Canadian infant mortality rates: Effect of changes in registration of live newborns weighing less than 500 g. CMAJ. 1996;155:1047–52. [PMC free article] [PubMed] [Google Scholar]
  • 9.Avery ME. A 50-year overview of perinatal medicine. Early Hum Dev. 1992;29:43–50. doi: 10.1016/0378-3782(92)90056-M. [DOI] [PubMed] [Google Scholar]
  • 10.Basinski A. Use of hospital resources. In: Naylor CD, Anderson GM, Goel V, editors. Patterns of Health Care in Ontario. Ottawa: Canadian Medical Association; 1994. pp. 165–306. [Google Scholar]
  • 11.Selker HP, Beshasky JR, Pauker SG, et al. The epidemiology of delays in a teaching hospital. The development and use of a tool that detects unnecessary hospital days. Med Care. 1989;27:112–19. doi: 10.1097/00005650-198902000-00003. [DOI] [PubMed] [Google Scholar]
  • 12.Baigelman W. Identifying physicians and patterns generating unnecessary in-hospital days. An exploratory stage of developing an institution-specific physician-focused utilization effort. Qual Assur Util Rev. 1991;6:95–98. doi: 10.1177/0885713x9100600307. [DOI] [PubMed] [Google Scholar]
  • 13.Gloor JE, Kissoon N, Joubert GI. Appropriateness of hospitalization in a Canadian pediatric hospital. Pediatrics. 1993;91:70–74. [PubMed] [Google Scholar]
  • 14.Wen SW, Liu S, Marcoux S, Fowler D. Trends and variations in maternal length of in-hospital stay in Canada. CMAJ (In press). [PMC free article] [PubMed]
  • 15.Centers for Disease ControlPrevention. Trends in length of stay for hospital deliveries-United States, 1970–1992. MMWR. 1995;44:335–37. [PubMed] [Google Scholar]
  • 16.Centers for Disease ControlPrevention. Average postpartum length of stay for uncomplicated deliveries-New Jersey, 1995. MMWR. 1996;45:700–4. [PubMed] [Google Scholar]
  • 17.Chance G. Ontario Medical Review. 1996. Examining difficulties associated with early discharge following birth; p. 40. [Google Scholar]
  • 18.Huston P, Naylor CD. Health services research: Reporting on studies using secondary data sources. CMAJ. 1996;15:1697–702. [PMC free article] [PubMed] [Google Scholar]
  • 19.Williams JI, Young W, et al. A summary of studies on the quality of health care administrative databases in Canada. In: Goel V, Williams JI, Anderson GM, et al., editors. Patterns of Health Care in Ontario. The ICES Practice Atlas. 2nd ed. Ottawa: Canadian Medical Association; 1996. pp. 339–45. [Google Scholar]
  • 20.Wen SW, Liu S, Marcoux S, Fowler D. Uses and limitations of routine hospital admission/separation records for perinatal surveillance. Chron Dis Can. 1997;18:113–18. [PubMed] [Google Scholar]
  • 21.Britton JR, Britton HL, Beebe SA. Early discharge of the term newborn: A continued dilemma. Pediatrics. 1994;94:291–95. [PubMed] [Google Scholar]
  • 22.Liu LL, Clemens CJ, Shay DK, et al. 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]
  • 23.Lee KS, Perlman M. The impact of early obstetric discharge on newborn health care. Current Opinion in Pediatrics. 1996;8:96–101. doi: 10.1097/00008480-199604000-00002. [DOI] [PubMed] [Google Scholar]
  • 24.Tully P, Saint-Pierre E. Downsizing Canada’s hospitals, 1986/87 to 1994/95. Health Rep. 1997;8:33–39. [Google Scholar]

Articles from Canadian Journal of Public Health = Revue Canadienne de Santé Publique are provided here courtesy of Springer

RESOURCES