title: Timing of initial well-child visit and readmissions of newborns.
abstract: OBJECTIVE
  Recommendations for the timing of the first well-child visit (WCV) after discharge from a well-baby nursery (WBN) suggest that the visit occur within 48 hours of discharge for those with a WBN length of stay of ≤48 hours and within 3 to 5 days for those with a WBN length of stay of >48 hours. The purpose of these early visits is to detect conditions that may cause readmission in the first weeks after birth, but the effectiveness of early visits to accomplish this has not been shown. The objectives of this study were to determine (1) the frequency of early visits and (2) to compare readmission rates for those who had an early visit compared with those who did not.
  
  
  METHODS
  Using data from a large health care system in Utah, we determined the readmission rates newborns with an estimated gestational age ≥34 weeks and compared the rates for those who had an early WCV with those who did not.
  
  
  RESULTS
  Of 79 720 newborns, 50 606 (63%) were discharged within 48 hours of birth. Of these, 7638 (15%) had a visit within 72 hours of discharge. The readmission rate for newborns who had a visit within the recommended time frame was 15.7 per 1000 compared with 18.4 for those with a later visit (odds ratio 0.85; 95% confidence interval 0.73-0.99) CONCLUSIONS: The frequency of first WCVs that occurred within the recommended time frames was low. Early visits were associated with a 15% reduction in the rate of readmissions.
authors: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah; and.
authors: Julie
authors: J
authors: Shakib
authors: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah; and.
authors: Karen
authors: K
authors: Buchi
authors: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah; and.
authors: Elizabeth
authors: E
authors: Smith
authors: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah; and Intermountain Healthcare, Pediatric Specialty Clinical Program, Salt Lake City, Utah.
authors: Kent
authors: K
authors: Korgenski
authors: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah; and paul.young@hsc.utah.edu.
authors: Paul C
authors: PC
authors: Young
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000628:therapy*; D007902:Length of Stay / Q000639:trends; D016017:Odds Ratio; D010359:Patient Readmission / Q000639:trends*; D011181:Postnatal Care / Q000379:methods*; D012189:Retrospective Studies; D014589:Utah / Q000453:epidemiology
keywords: newborns; readmissions; well child visits