title: Description and evaluation of a program for the early discharge of infants from a neonatal intensive care unit.
abstract: The effect of a cost-containment program focused on decreasing the lengths of hospital stay of high-risk neonates was assessed by comparison of discharge weights and lengths of stay for 257 study infants, discharged from a neonatal intensive care unit (NICU) after an early-discharge program began, with those of 477 control infants discharged during a prior 1-year period. Demographic data and costs, as well as data on emergency department use and hospital readmissions, were included in the comparisons. There was a significant decrease in mean discharge weight and length of stay for infants in the study group. During a 7-month period, an estimated 2073 days of hospital care and approximately $2,700,000 in hospital charges were saved, or $10,609 per infant discharged. The cost of instituting and maintaining the program was $120,413, or $468 per infant. Seven visits were made to the emergency department by the study infants during the first 14 days after discharge. One infant was readmitted for a 4-day hospital stay for suspected sepsis. Significantly earlier discharge of high-risk neonates produced a decrease in hospital charges without causing excessive morbidity. The success of the program was coincident and presumed related to the institution of multiple elements focused toward family support through early-discharge planning. The reduction in hospital charges was 30 times higher than program expenses.
authors.affiliation: Center for Clinical Effectiveness, University of Cincinnati and Children's Hospital Medical Center, OH, USA.
authors.forename: U R
authors.initials: UR
authors.lastname: Kotagal
authors.forename: P H
authors.initials: PH
authors.lastname: Perlstein
authors.forename: V
authors.initials: V
authors.lastname: Gamblian
authors.forename: E F
authors.initials: EF
authors.lastname: Donovan
authors.forename: H D
authors.initials: HD
authors.lastname: Atherton
mesh_terms: D000359:Aftercare / Q000191:economics; D016022:Case-Control Studies; D003363:Cost Control; D005260:Female; D006699:Home Care Services / Q000191:economics; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000191:economics / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000191:economics*; D008297:Male; D009820:Ohio; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D010359:Patient Readmission; D016730:Program Development; D015397:Program Evaluation; D013997:Time Factors