Unreadiness for postpartum discharge following healthy term pregnancy: impact on health care use and outcomes.
Acad Pediatr
; 13(1): 27-39, 2013.
Article
em En
| MEDLINE
| ID: mdl-23098743
ABSTRACT
OBJECTIVE:
To document the association between a lack of readiness, termed "unreadiness," for postpartum discharge and the health of mothers and their term newborns.METHODS:
Prospective observational cohort study of 4300 mother-infant dyads in a national, pediatric, practice-based research network. The association between unreadiness for discharge and health care use, health-related behaviors, and health outcomes was analyzed by the use of bivariate, multivariate linear, and logistic models.RESULTS:
Sixteen percent of mother-infant dyads were unready for discharge. Unreadiness was significantly associated with maternal and infant health care use and health outcomes but not independently associated with health-related behaviors. In multivariable analyses, after we controlled for important covariates and confounders, unready dyads had more calls to health care providers than ready dyads (13.3% increase for mothers, P = .01; 18.7% increase for infants, P < .01) during the first 2 weeks after discharge. In this same time frame, unready dyads also had more symptom days (8.5% increase for mothers, P < .01; 8.7% increase for infants, P < .01). Unready mothers had lower mean physical (5.0% decrease, P < .01) and mental (4.4% decrease, P < .01) health status scores at 4 weeks after discharge.CONCLUSIONS:
Unreadiness at postpartum discharge was associated with increased health care use and poorer health outcomes in the first 2 to 4 weeks after discharge. Discharge plans should be individualized and jointly tailored to a family's needs rather than to a set timescale.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Alta do Paciente
/
Comportamentos Relacionados com a Saúde
/
Serviços de Saúde da Criança
/
Período Pós-Parto
/
Serviços de Saúde Materna
/
Mães
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Newborn
/
Pregnancy
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article