Document Detail


Postpartum discharge preferences of pediatricians: results from a national survey.
MedLine Citation:
PMID:  12093946     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify practice/physician characteristics that influence pediatricians' self-reported newborn discharge practices. METHODS: Of the pediatricians randomly surveyed through a national American Academy of Pediatrics periodic survey conducted in 2000, 490 were identified as routinely providing care for newborns in the nursery. These respondents rated the importance of 22 infant, maternal, and peripartum factors in determining readiness for nursery discharge on a 5-point Likert scale and reported their perceptions of optimal and minimal lengths of stay (LOS) for healthy term newborns. Importance of readiness factors was dichotomized as "high" (very important or important) versus "low" (neither, unimportant, or very unimportant). Relationships between pediatricians' responses and demographic information were explored using multivariate logistic regression. RESULTS: Most pediatricians (at least 81%) rated all 7 infant clinical factors (eg, stable, normal vital signs, successful feeding) as highly important determinants of discharge readiness. Women were 2 to 3 times more likely to rate maternal and peripartum factors such as maternal fatigue and stress, demonstration of maternal skills, breastfeeding knowledge or experience, adequacy of social support, maternal age <18 years, and low income/lack of financial resources as highly important. With respect to hospital LOS, women were twice as likely to identify an optimal LOS as >36 hours and a minimal LOS as >24 hours. Pediatricians in group settings were 3 times as likely as those in solo or 2-physician practices to advocate an optimal LOS >36 hours, and those with a high proportion of publicly insured or uninsured patients were less likely to identify an optimal LOS as >36 hours (odds ratio: 0.53). CONCLUSIONS: Female pediatricians report a more biopsychosocial approach to determining discharge readiness than their male counterparts, taking into account infant characteristics, maternal skills, and socioemotional issues that may affect the mother-infant pair's adjustment at home. The finding that those who provide care for the most financially vulnerable patients do not see the need for longer LOS is both surprising and of concern. The results support the need for a prospective critical examination of perinatal hospital discharge practices, such as the Pediatric Research in Office Settings Life Around Newborn Discharge Study.
Authors:
John R Britton; Alison Baker; Cathie Spino; Henry H Bernstein
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  110     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-02     Completed Date:  2002-08-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  53-60     Citation Subset:  AIM; IM    
Affiliation:
Pediatric Research in Office Settings (PROS), American Academy of Pediatrics, Elk Grove Village, Illinois, USA.
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MeSH Terms
Descriptor/Qualifier:
Attitude of Health Personnel*
Female
Health Care Surveys
Humans
Infant Care* / statistics & numerical data
Infant, Newborn*
Length of Stay
Logistic Models
Male
Maternal Age
Nurseries, Hospital / statistics & numerical data
Patient Discharge / standards*
Pediatrics / statistics & numerical data*
Physician's Practice Patterns
Physicians, Women / statistics & numerical data
Postpartum Period*
Random Allocation
Sampling Studies
Sex Factors
Comments/Corrections
Erratum In:
Pediatrics 2002 Sep;110(3):650

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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