Receipt of home health care after early discharge: results from a national managed care organization.
OBJECTIVE
To determine the frequency of home visits during the postpartum period among women discharged within 24 hours after childbirth, to identify characteristics of women who received at least one home visit, and to examine whether a home visit was related to postpartum experiences.


METHODS
Women who were enrolled in a Prudential HealthCare plan and had a recent normal vaginal delivery completed a 15-minute telephone survey (N = 5201). Only women who were discharged within 24 hours after delivery were included in this analysis (N = 3121). Selected variables, including maternal characteristics, pregnancy-related and postpartum experiences, and social support factors, were compared for women who received visits and those who did not receive visits within two weeks after delivery.


RESULTS
Slightly more than 30% of women participating in the survey received at least one home health care visit within 2 weeks after delivery discharge. Women who received a home visit were more likely to be Black, employed, primaparous, enrolled in a health maintenance organization, or not living in the Southern United States. Compared with women who did not receive a home visit, women who received a visit were more likely to have their newborn receive a phenylketonuria test after discharge, receive a follow-up phone call or housekeeping service, and access to a 24-hour hotline.


CONCLUSIONS
Managed care organizations as well as other organized systems of care should be focused on improving the quality of prenatal and postpartum services, and increasing satisfaction of women using these services.
Gazmararian
J A
JA
Prudential Center for Health Care Research, Atlanta, Georgia 30339, USA. julie.gazmararian@prudential.com
Solomon
F M
FM
D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003625:Data Collection; D005260:Female; D005845:Georgia; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008329:Managed Care Programs / Q000458:organization & administration / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data*; D049590:Postpartum Period; D011247:Pregnancy; D015397:Program Evaluation; D012016:Reference Values; D018570:Risk Assessment; D016387:Women's Health