Early discharge: its impact on low-income mothers and newborns in the state of Hawaii.
OBJECTIVE
The objectives of this survey were to investigate whether, in the state of Hawaii, early discharge had a negative effect on the health of new mothers and their infants, especially those at high sociodemographic risk, and whether early discharge was implemented in compliance with the early-discharge guidelines of the American Academy of Pediatrics (AAP), and the American College of Obstetricians and Gynecologists (ACOG).


METHODS
This statewide survey was conducted from June 17 through July 12, 1996. The data was collected and recorded by perinatal providers at 14 PSS (Perinatal Support Services) sites through interviews of mothers using questionnaires. This report is based on the 108 questionnaires that were returned from the PSS sites. A descriptive analysis was performed, using the statistical/epidemiologic program EPI INFO 6.


RESULTS
The survey reveals that the practice of early discharge had been implemented extensively but not in compliance with AAP/ACOG early discharge guidelines. The neonatal readmission rate for this survey group was 6.5% among low-income mothers and infants. This was found to be among the highest rates reported in the United States and Canada; in the United States, reported neonatal readmission rates vary from 1 to 4%.


CONCLUSIONS
Early discharge greatly contributes to negative outcomes among low-income mothers and infants. This paper reports on the results of this survey in Hawaii and recommends a comprehensive approach for promoting the health and well-being of low-income mothers and infants.
Taniguchi
H
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School of Nursing, Saga Medical School, Japan.
D000293:Adolescent; D000328:Adult; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D006254:Hawaii; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D007902:Length of Stay; D008427:Maternal Health Services / Q000592:standards*; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D011181:Postnatal Care; D011203:Poverty; D011247:Pregnancy