title: Unreadiness for postpartum discharge following healthy term pregnancy: impact on health care use and outcomes.
abstract: OBJECTIVE
  To document the association between a lack of readiness, termed "unreadiness," for postpartum discharge and the health of mothers and their term newborns.
  
  
  METHODS
  Prospective observational cohort study of 4300 mother-infant dyads in a national, pediatric, practice-based research network. The association between unreadiness for discharge and health care use, health-related behaviors, and health outcomes was analyzed by the use of bivariate, multivariate linear, and logistic models.
  
  
  RESULTS
  Sixteen percent of mother-infant dyads were unready for discharge. Unreadiness was significantly associated with maternal and infant health care use and health outcomes but not independently associated with health-related behaviors. In multivariable analyses, after we controlled for important covariates and confounders, unready dyads had more calls to health care providers than ready dyads (13.3% increase for mothers, P = .01; 18.7% increase for infants, P < .01) during the first 2 weeks after discharge. In this same time frame, unready dyads also had more symptom days (8.5% increase for mothers, P < .01; 8.7% increase for infants, P < .01). Unready mothers had lower mean physical (5.0% decrease, P < .01) and mental (4.4% decrease, P < .01) health status scores at 4 weeks after discharge.
  
  
  CONCLUSIONS
  Unreadiness at postpartum discharge was associated with increased health care use and poorer health outcomes in the first 2 to 4 weeks after discharge. Discharge plans should be individualized and jointly tailored to a family's needs rather than to a set timescale.
authors.affiliation: Department of Pediatrics, Hofstra North Shore-LIJ School of Medicine, Cohen Children's Medical Center of NY, New Hyde Park, NY 11042, USA. hbernstein@nshs.edu
authors.forename: Henry H
authors.initials: HH
authors.lastname: Bernstein
authors.forename: Cathie
authors.initials: C
authors.lastname: Spino
authors.forename: Christina M
authors.initials: CM
authors.lastname: Lalama
authors.forename: Stacia A
authors.initials: SA
authors.lastname: Finch
authors.forename: Richard C
authors.initials: RC
authors.lastname: Wasserman
authors.forename: Marie C
authors.initials: MC
authors.lastname: McCormick
mesh_terms: D000328:Adult; D002662:Child Health Services / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D016015:Logistic Models; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D010351:Patient Discharge; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult