Department of Pediatrics, The University of Utah School of Medicine, Salt Lake City, UT 84158, USA.
Pediatrics. 2013 May;131(5):e1538-44. doi: 10.1542/peds.2012-2634. Epub 2013 Apr 8.
Early readmissions of apparently healthy newborns after discharge from well baby nurseries (WBN) may reflect an inadequate assessment of the newborn's readiness for discharge.
To determine the frequency, causes, costs, and variations in rates of early rehospitalization of newborns discharged from 21 WBNs in 1 health care system.
We queried the Enterprise Data Warehouse of Intermountain Healthcare (IH), a large Utah health care system, to identify newborns with gestational ages of 34 to 42 weeks discharged from an IH WBN between 2000 and 2010. We identified all newborns admitted to an IH hospital within 28 days of discharge and recorded their birth hospital, age, reason(s) for admission, length of stay, and inpatient costs.
During the study period, 296 114 infants were discharged from IH hospital WBNs. Of these, 5308 (17.9/1000) were readmitted within 28 days of discharge. Of the 5308 infants who were readmitted, 41% had feeding problems, 35% had jaundice, and 33% had respiratory distress. The majority of newborns with feeding problems and jaundice were admitted in their first 2 weeks of life. Late preterm and early term newborns had higher rates of readmission than term infants. There were significant variations in readmission rates of newborns born at the 21 hospitals in the IH system.
Potentially preventable conditions, including feeding problems and jaundice, account for most early readmissions of newborns. Late preterm and early term newborns have higher rates of readmission and should be assessed for other factors associated with early readmission.
显然健康的新生儿在离开婴儿特别护理病房（WBN）后早期再次入院可能反映了对新生儿出院准备情况的评估不足。
确定在一个医疗保健系统的 21 个 WBN 出院的新生儿早期再次住院的频率、原因、成本和变化率。
我们查询了 Intermountain Healthcare（IH）的企业数据仓库，该数据仓库是一个大型犹他州医疗保健系统，以确定在 2000 年至 2010 年期间从 IH WBN 出院的胎龄为 34 至 42 周的新生儿。我们确定了所有在出院后 28 天内入住 IH 医院的新生儿，并记录了他们的出生医院、年龄、入院原因、住院时间和住院费用。
在研究期间，296114 名婴儿从 IH 医院 WBN 出院。其中，5308 人（17.9/1000）在出院后 28 天内再次入院。在 5308 名再次入院的婴儿中，41%有喂养问题，35%有黄疸，33%有呼吸窘迫。大多数有喂养问题和黄疸的新生儿在出生后的前 2 周内入院。晚期早产儿和早期早产儿的再入院率高于足月婴儿。IH 系统 21 家医院的新生儿再入院率存在显著差异。
包括喂养问题和黄疸在内的潜在可预防的疾病占新生儿早期再入院的大多数。晚期早产儿和早期早产儿的再入院率较高，应评估与早期再入院相关的其他因素。
