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Early Discharge of Newborns

Joseph V. Cook Jr, MD; Charles L. Woronick, PhD; Howard W. Wetstone, MD; Patricia Lariviere, RN, MS; David V. Williams
JAMA. 1997;278(23):2065. doi:10.1001/jama.1997.03550230041028.
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To the Editor.  —Two articles1,2 concerning early discharge of newborns came to contradictory conclusions concerning whether early discharge is associated with increased risk of rehospitalization, as discussed in the accompanying Commentary.3 This prompted us to relate the experience of MedSpan, a Connecticut-based, provider-sponsored managed care organization, with a voluntary early discharge program offered to our policyholders and the effect of Connecticut state legislation.Mothers and their healthy infants who met physician-established criteria and volunteered to be discharged from the hospital within 30 hours of normal vaginal delivery were offered 2 skilled nursing visits at home, 16 hours of nanny care, and 1 extra pediatric office visit. We analyzed utilization of services among 77 consecutive mothers who used the program during a 19-month period beginning January 1, 1996 (unpublished data, August 1997). We found that 1 mother did not use any nursing visits, 5 used 1 visit, 70 used 2 visits, and 1


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