Early postpartum discharge at a university hospital - Outcome analysis

OBJECTIVE: To determine whether implementation of an early hospital dischar ge policy was effective in safely reducing hospital stay and acceptable to patients. STUDY DESIGN: The study was a prospective, observational trial. Early disch arge was defined as discharge from the hospital either on the first day aft er vaginal delivery or on the second day after delivery by cesarean section . A "stayover mom" policy was subsequently implemented to allow a mother th e option to remain in the hospital overnight after discharge. This prospect ive study was divided into three consecutive three-month periods: (1) routi ne care (n=576), (2) early discharge (n=622), and (3) early discharge with stay-over mom (n=574). Primary outcome measurements were length of hospital stay and patient willingness. RESULTS: With proper review of written instructions, all eligible patients were willing to be discharged early. As compared with the routine care grou p, the length of hospital stay was shorter by 0.8 days (95% CI, 0.4-1.2 day s) in the early discharge group (P < .01) and by 1.1 days (95% CI, 0.5-1.7 days) in the early discharge with stayover mom policy was more desirable be cause of limitations in obtaining timely transportation and concern about t he infant warranting continued observation. The need for maternal readmissi on was rare (15 cases, 0.8% of total), with endometritis equally common (n= 3 in each group). CONCLUSION: Early postpartum discharge, especially including a stayover mom policy, was acceptable to our predominantly Medicaid population. The reduc ed hospital stay was not associated with increased maternal morbidity.