Protocols for early discharging of premature infants: an empirical assessment on safety and savings
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Chiara Daicampi
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.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review
- The role of complement in preterm birth and prematurity
- Original Articles – Obstetrics
- Variation in C-reactive protein at 1 month post-partum by etiology of preterm birth: selective identification of those at risk for both poor pregnancy outcome and future health complications
- Procedure related risk of premature delivery and fetal growth reduction following amniocentesis, transcervical and transabdominal chorionic villus sampling: a retrospective study
- Cervical length at 31–34 weeks of gestation: transvaginal vs. transperineal ultrasonographic approach
- The origin of amniotic fluid monocytes/macrophages in women with intra-amniotic inflammation or infection
- Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction
- A 17-years analysis of terminations of pregnancy ≥14 weeks of gestation in a German level 1 perinatal center
- Simulation of an impacted fetal head extraction during cesarean section: description of the creation and evaluation of a new training program
- Academic tweeting in #ObGyn. Where do we stand?
- Original Articles – Fetus
- Fetal heart examination at the time of 13 weeks scan: a 5 years’ prospective study
- Comparison of fetal cardiac functions between small-for-gestational age fetuses and late-onset growth-restricted fetuses
- Original Article – Newborn
- Protocols for early discharging of premature infants: an empirical assessment on safety and savings
- Letter to the Editor
- Maternal blood pressure levels prepartum correlate with neonatal birth weight in preeclampsia
Articles in the same Issue
- Frontmatter
- Review
- The role of complement in preterm birth and prematurity
- Original Articles – Obstetrics
- Variation in C-reactive protein at 1 month post-partum by etiology of preterm birth: selective identification of those at risk for both poor pregnancy outcome and future health complications
- Procedure related risk of premature delivery and fetal growth reduction following amniocentesis, transcervical and transabdominal chorionic villus sampling: a retrospective study
- Cervical length at 31–34 weeks of gestation: transvaginal vs. transperineal ultrasonographic approach
- The origin of amniotic fluid monocytes/macrophages in women with intra-amniotic inflammation or infection
- Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction
- A 17-years analysis of terminations of pregnancy ≥14 weeks of gestation in a German level 1 perinatal center
- Simulation of an impacted fetal head extraction during cesarean section: description of the creation and evaluation of a new training program
- Academic tweeting in #ObGyn. Where do we stand?
- Original Articles – Fetus
- Fetal heart examination at the time of 13 weeks scan: a 5 years’ prospective study
- Comparison of fetal cardiac functions between small-for-gestational age fetuses and late-onset growth-restricted fetuses
- Original Article – Newborn
- Protocols for early discharging of premature infants: an empirical assessment on safety and savings
- Letter to the Editor
- Maternal blood pressure levels prepartum correlate with neonatal birth weight in preeclampsia
