Protocols for early discharging of premature infants: an empirical assessment on safety and savings.
J Perinat Med
; 47(8): 885-893, 2019 Oct 25.
Article
em En
| MEDLINE
| ID: mdl-31421044
ABSTRACT
Background Preterm newborns may be discharged when clinical conditions are stable. Several criteria for early discharge have been proposed in the literature. This study carried out the first quantitative comparison of their impact in terms of hospitalization savings, safety and costs. Methods This study was based on the clinical histories of 213 premature infants born in the Neonatal Intensive Care Unit of Padova University Hospital between 2013 and 2014. Seventeen early discharge criteria were drawn from the literature and retrospectively applied to these data, and computation of hospitalization savings, safety and costs implied by each criterion was carried out. Results Among the criteria considered, average gains ranged from 1.1 to 10.3 hospital days and between 0.3 and 1.1 fewer infections per discharged infant. Criteria that led to saving more hospital days had higher cost-effectiveness in terms of crisis and infection, and they spared infants from more infections. However, episodes of apnea and bradycardia were detected after the potential early discharge date for all criteria, with a mean number of episodes numbering between 0.3 and 1.4. Conclusion The results highlight a clear trade-off between days saved and health risks for infants, with potential consequences for health care costs.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Alta do Paciente
/
Unidades de Terapia Intensiva Neonatal
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Protocolos Clínicos
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Lactente Extremamente Prematuro
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
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Humans
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Male
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Newborn
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Perinat Med
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Itália