Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers

Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Impact of Early Newborn Discharge Legislation and Early Follow-up Visits on Infant Outcomes in a State Medicaid Population

Ellen Meara, Uma R. Kotagal, Harry D. Atherton and Tracy A. Lieu
Pediatrics June 2004, 113 (6) 1619-1627; DOI: https://doi.org/10.1542/peds.113.6.1619
Ellen Meara
*Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
‡National Bureau of Economic Research, Cambridge, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Uma R. Kotagal
§Center for Health Policy & Clinical Effectiveness
‖Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
¶Institute of Health Policy and Health Services Research, University of Cincinnati, Cincinnati, Ohio
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Harry D. Atherton
§Center for Health Policy & Clinical Effectiveness
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tracy A. Lieu
#Center for Child Health Care Studies, Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School, Boston, Massachusetts
**Division of General Pediatrics, Children's Hospital Boston, Boston, Massachuestts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Abstract

Objective. Scant information exists on the effects of legislation mandating coverage of minimum postnatal hospital stays on infant health outcomes. There are also gaps in knowledge regarding the effectiveness of early follow-up visits for newborns. The objective of this study was to determine the impact of 1) legislation mandating coverage of minimum postnatal hospital stays and 2) early follow-up visits by the age of 4 days on infant outcomes during the first month of life.

Methods. A retrospective analysis was conducted of Ohio Medicaid claims data linked with birth certificate data for the period 1991-1998. The impact of the legislation was evaluated using interrupted time-series analysis of health-related utilization. The effects of early follow-up visits for vaginally delivered newborns with short stays were analyzed using the day of the week on which the birth occurred (eg, Monday, Tuesday) as an instrumental variable to account for potential confounding. A total of 155 352 full-term newborns who were born to mothers who receive Medicaid were studied. The main outcomes measured were rehospitalizations, emergency department (ED) visits, and diagnoses of dehydration and infection within 10 and 21 days of birth.

Results. Few outcomes exhibited significant changes after legislation mandating coverage of minimum postnatal hospital stays. Rates of rehospitalization for jaundice within 10 days of birth fell from 0.78% to 0.47% in the year after legislation was introduced but leveled off after the legislation took effect. Rates of ED visits within 21 days increased from 6.0% to 10.4% during periods of increasing short stay but fell to 8.0% during the year after introduction of the legislation and leveled off when the legislation took effect. Rates of all-cause rehospitalization, dehydration, and infection diagnoses showed no consistent relationship to Ohio's legislation. Using instrumental variable analysis, newborns who received early follow-up visits were significantly less likely to have rehospitalizations within the first 10 days of life than those who did not.

Conclusions. In this state Medicaid population, legislation mandating coverage of minimum postnatal hospital stays was associated with reductions in the rates of rehospitalization for jaundice and ED visits. For newborns with short stays, early follow-up visits may reduce rehospitalizations in the early postpartum period.

  • length of stay
  • newborn
  • legislation
  • follow-up
  • Medicaid
  • Received February 20, 2003.
  • Accepted July 18, 2003.
  • Copyright © 2004 by the American Academy of Pediatrics

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics
Vol. 113, Issue 6
1 Jun 2004
  • Table of Contents
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Impact of Early Newborn Discharge Legislation and Early Follow-up Visits on Infant Outcomes in a State Medicaid Population
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Impact of Early Newborn Discharge Legislation and Early Follow-up Visits on Infant Outcomes in a State Medicaid Population
Ellen Meara, Uma R. Kotagal, Harry D. Atherton, Tracy A. Lieu
Pediatrics Jun 2004, 113 (6) 1619-1627; DOI: 10.1542/peds.113.6.1619

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Impact of Early Newborn Discharge Legislation and Early Follow-up Visits on Infant Outcomes in a State Medicaid Population
Ellen Meara, Uma R. Kotagal, Harry D. Atherton, Tracy A. Lieu
Pediatrics Jun 2004, 113 (6) 1619-1627; DOI: 10.1542/peds.113.6.1619
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Abstract
    • METHODS
    • RESULTS
    • DISCUSSION
    • CONCLUSIONS
    • Acknowledgments
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Early Postnatal Discharge for Infants: A Meta-analysis
  • Parental characteristics and perspectives pertaining to neonatal visits to the emergency department: a multicentre survey
  • Evaluating Educational Needs of Parents at Newborn Discharge: A Pilot Study
  • Association between day of delivery and obstetric outcomes: observational study
  • Hospital Stay for Healthy Term Newborn Infants
  • Timing of Initial Well-Child Visit and Readmissions of Newborns
  • Early Discharge of Infants and Risk of Readmission for Jaundice
  • Early Readmission of Newborns in a Large Health Care System
  • Length of Stay and Readmission Among Late Preterm Infants: An Instrumental Variable Approach
  • The Differential Impact of Delivery Hospital on the Outcomes of Premature Infants
  • Adherence to Discharge Guidelines for Late-Preterm Newborns
  • Hospital Stay for Healthy Term Newborns
  • Trends in Pediatric and Adult Bicycling Deaths Before and After Passage of a Bicycle Helmet Law
  • Improving Newborn Preventive Services at the Birth Hospitalization: A Collaborative, Hospital-Based Quality-Improvement Project
  • Preventable Newborn Readmissions Since Passage of the Newborns' and Mothers' Health Protection Act
  • Impact of Postpartum Hospital-Stay Legislation on Newborn Length of Stay, Readmission, and Mortality in California
  • Medicaid Acceptance and Availability of Timely Follow-up for Newborns With Medicaid
  • Cost-Effectiveness of Strategies That Are Intended to Prevent Kernicterus in Newborn Infants
  • Hyperbilirubinemia Guidelines and Unintended Harms: In Reply
  • Google Scholar

More in this TOC Section

  • Applications of Artificial Intelligence for Retinopathy of Prematurity Screening
  • Phenobarbital and Clonidine as Secondary Medications for Neonatal Opioid Withdrawal Syndrome
  • A Prevention Program for Insomnia in At-risk Adolescents: A Randomized Controlled Study
Show more Articles

Similar Articles

Subjects

  • Fetus/Newborn Infant
    • Fetus/Newborn Infant
    • Neonatology
  • Hospital Medicine
    • Hospital Medicine
    • Continuity of Care Transition & Discharge Planning

Keywords

  • length of stay
  • newborn
  • legislation
  • follow-up
  • medicaid
  • ED, emergency department
  • AAP, American Academy of Pediatrics
  • IV, instrumental variable
  • Journal Info
  • Editorial Board
  • Editorial Policies
  • Overview
  • Licensing Information
  • Authors/Reviewers
  • Author Guidelines
  • Submit My Manuscript
  • Open Access
  • Reviewer Guidelines
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
  • RSS
American Academy of Pediatrics

© 2021 American Academy of Pediatrics