title: [Precarious parturients and readmission: pilot study at the Lariboisière-Fernand-Widal Hospital Group in Paris].
abstract: OBJECTIVE
  We wondered whether pregnant women with social handicap benefited from readmissions which could have been prevented, and if there was a selection of patients?
  
  
  METHODS
  This is a retrospective study of 127 pregnant women with social handicap having given natural childbirth in a public health establishment. The research was based on analysis of data from DRG's (PMSI), legislation and other documents.
  
  
  RESULTS
  Between mid March 2007 and mid June 2009, 27 of the 127 pregnant women with social handicap have benefited from 35 readmissions. There were 171.5 ± 255.1 days between readmissions. There was no second readmission on the same day for the same patient. According to the criteria of the Appropriateness Evaluation Protocol (AEPf), none of the readmissions were considered avoidable. No parturient was readmitted for non-medical reasons. Readmitted patients presented low to severe social handicaps and had 79.6 % more coded diagnosis compared to their first hospitalization. This service plays its public service role to fight against social exclusion.
  
  
  CONCLUSIONS
  This pilot study provides encouraging results but also underlines the limits of our approach. We nevertheless wished to explore whether this low resource intensive initiative could make interesting indicators emerge, which seems to be the case.
authors.affiliation: Université Paris, 8, Vincennes-Saint-Denis, 2, rue de la Liberté, 93526 Saint-Denis cedex, France.
authors.forename: R
authors.initials: R
authors.lastname: Atete-Leblanc
authors.forename: P-H
authors.initials: PH
authors.lastname: Bréchat
authors.forename: O
authors.initials: O
authors.lastname: Morel
authors.forename: A
authors.initials: A
authors.lastname: Thoury
authors.forename: A
authors.initials: A
authors.lastname: Frati
authors.forename: E
authors.initials: E
authors.lastname: Barranger
mesh_terms: D036861:Delivery, Obstetric; D006233:Persons with Disabilities; D005260:Female; D054625:Healthcare Disparities; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D010297:Paris; D010359:Patient Readmission; D010865:Pilot Projects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy; D011644:Puerperal Disorders / Q000628:therapy; D012189:Retrospective Studies