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Increased Neonatal Readmission Rate Associated with Decreased Length of Hospital Stay at Birth in Canada

Abstract

Purpose: To assess the potential impact of early post birth discharge in Canada.

Methods: Neonatal readmission was examined, based on hospital discharge data from the Canadian Institute for Health Information, with a total of 2,144,205 infants from fiscal year 1989/90 to fiscal year 1996/97.

Results: Neonatal readmission rates increased from 27.3 per 1,000 in 1989/90 to 38.0 per 1,000 in 1996/97, while mean length of hospital stay at birth decreased from 4.2 days to 2.7 days during the same period. The increase in readmission rate was more evident for dehydration and jaundice. The provinces and territories with decreased length of hospital stay at birth usually had increased neonatal readmission rate and earlier age at readmission. Between 1994/95 and 1996/97, compared with Newfoundland, the risks for neonatal readmission for dehydration were 5.7 and 5.5, and for jaundice were 4.5 and 2.7, respectively, for Alberta and Ontario.

Conclusion: Neonatal readmission rates for several conditions have increased substantially, associated with early post birth discharge policies adopted in Canada.

Résumé

But: Évaluer l’impact potentiel des sorties précoces de l’hôpital après la naissance.

Méthodologie: Examen des réadmissions néonatales à partir des données sur les sorties d’hôpital fournies par l’Institut canadien d’information sur la santé, portant sur un total de 2 144 205 nouveau-nés, de l’année civile 1989–1990 à l’année civile 1996–1997.

Résultats: Les taux de réadmission néonatale sont passés de 27,3 pour 1 000 en 1989–1990 à 38 pour 1 000 en 1996–1997 alors que la moyenne du séjour à l’hôpital après la naissance passait de 4,2 à 2,7 jours pendant la même période. L’augmentation du taux de réadmission était encore plus marqué pour les cas de déshydratation et de jaunisse. Les provinces et les territoires pour lesquels il y avait diminution de la durée du séjour à l’hôpital après la naissance avaient habituellement des taux de réadmission néonatale plus élevés, et l’âge de réadmission du nouveau-né était inférieur. Entre 1994–1995 et 1996–1997, en comparaison avec Terre-Neuve, les risques de réadmission néonatale pour déshydratation étaient de 5,7 et de 5,5 respectivement pour l’Alberta et l’Ontario; pour la jaunisse, ils étaient de 4,5 et 2,7 respectivement.

Conclusion: Les taux de réadmission néonatale pour certaines affections ont substantiellement augmenté et sont associés à l’adoption au Canada de politiques autorisant des sorties précoces de l’hôpital après la naissance.

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Correspondence to Catherine McCourt MD, MHA, FRCPC.

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Liu, S., Wen, S.W., McMillan, D. et al. Increased Neonatal Readmission Rate Associated with Decreased Length of Hospital Stay at Birth in Canada. Can J Public Health 91, 46–50 (2000). https://doi.org/10.1007/BF03404253

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