tetano
Editor, Senior Moderator
Pediatrics
. 2021 Dec 10;e2021053498.
doi: 10.1542/peds.2021-053498. Online ahead of print.
Birth Hospital Length of Stay and Rehospitalization During COVID-19
Sara C Handley[SUP] 1 2 3 [/SUP], Kieran Gallagher[SUP] 4 [/SUP], Amy Breden[SUP] 4 [/SUP], Eric Lindgren[SUP] 4 [/SUP], Justin Y Lo[SUP] 4 [/SUP], Moeun Son[SUP] 5 [/SUP], Daria Murosko[SUP] 1 [/SUP], Kevin Dysart[SUP] 1 2 [/SUP], Scott A Lorch[SUP] 1 2 3 [/SUP], Jay Greenspan[SUP] 6 7 8 [/SUP], Jennifer F Culhane[SUP] 5 [/SUP], Heather H Burris[SUP] 1 2 3 [/SUP]
Affiliations
Abstract
Objectives: To determine if birth hospitalization length of stay (LOS) and infant rehospitalization changed during the coronavirus disease 2019 (COVID-19) era among healthy, term infants.
Methods: Retrospective cohort study using Epic's Cosmos data from 35 health systems of term infants discharged ≤5 days of birth. Short birth hospitalization LOS (vaginal birth <2 midnights; cesarean birth <3 midnights) and, secondarily, infant rehospitalization ≤7 days after birth hospitalization discharge were compared between the COVID-19 (March 1 to August 31, 2020) and prepandemic eras (March 1 to August 31, 2017, 2018, 2019). Mixed-effects models were used to estimate adjusted odds ratios (aORs) comparing the eras.
Results: Among 202 385 infants (57 110 from the COVID-19 era), short birth hospitalization LOS increased from 28.5% to 43.0% for all births (vaginal: 25.6% to 39.3%, cesarean: 40.1% to 61.0%) during the pandemic and persisted after multivariable adjustment (all: aOR 2.30, 95% confidence interval [CI] 2.25-2.36; vaginal: aOR 2.12, 95% CI 2.06-2.18; cesarean: aOR 3.01, 95% CI 2.87-3.15). Despite shorter LOS, infant rehospitalizations decreased slightly during the pandemic (1.2% to 1.1%); results were similar in adjusted analysis (all: aOR 0.83, 95% CI 0.76-0.92; vaginal: aOR 0.82, 95% CI 0.74-0.91; cesarean: aOR 0.87, 95% CI 0.69-1.10). There was no change in the proportion of rehospitalization diagnoses between eras.
Conclusions: Short infant LOS was 51% more common in the COVID-19 era, yet infant rehospitalization within a week did not increase. This natural experiment suggests shorter birth hospitalization LOS among family- and clinician-selected, healthy term infants may be safe with respect to infant rehospitalization, although examination of additional outcomes is needed.
. 2021 Dec 10;e2021053498.
doi: 10.1542/peds.2021-053498. Online ahead of print.
Birth Hospital Length of Stay and Rehospitalization During COVID-19
Sara C Handley[SUP] 1 2 3 [/SUP], Kieran Gallagher[SUP] 4 [/SUP], Amy Breden[SUP] 4 [/SUP], Eric Lindgren[SUP] 4 [/SUP], Justin Y Lo[SUP] 4 [/SUP], Moeun Son[SUP] 5 [/SUP], Daria Murosko[SUP] 1 [/SUP], Kevin Dysart[SUP] 1 2 [/SUP], Scott A Lorch[SUP] 1 2 3 [/SUP], Jay Greenspan[SUP] 6 7 8 [/SUP], Jennifer F Culhane[SUP] 5 [/SUP], Heather H Burris[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 34889449
- DOI: 10.1542/peds.2021-053498
Abstract
Objectives: To determine if birth hospitalization length of stay (LOS) and infant rehospitalization changed during the coronavirus disease 2019 (COVID-19) era among healthy, term infants.
Methods: Retrospective cohort study using Epic's Cosmos data from 35 health systems of term infants discharged ≤5 days of birth. Short birth hospitalization LOS (vaginal birth <2 midnights; cesarean birth <3 midnights) and, secondarily, infant rehospitalization ≤7 days after birth hospitalization discharge were compared between the COVID-19 (March 1 to August 31, 2020) and prepandemic eras (March 1 to August 31, 2017, 2018, 2019). Mixed-effects models were used to estimate adjusted odds ratios (aORs) comparing the eras.
Results: Among 202 385 infants (57 110 from the COVID-19 era), short birth hospitalization LOS increased from 28.5% to 43.0% for all births (vaginal: 25.6% to 39.3%, cesarean: 40.1% to 61.0%) during the pandemic and persisted after multivariable adjustment (all: aOR 2.30, 95% confidence interval [CI] 2.25-2.36; vaginal: aOR 2.12, 95% CI 2.06-2.18; cesarean: aOR 3.01, 95% CI 2.87-3.15). Despite shorter LOS, infant rehospitalizations decreased slightly during the pandemic (1.2% to 1.1%); results were similar in adjusted analysis (all: aOR 0.83, 95% CI 0.76-0.92; vaginal: aOR 0.82, 95% CI 0.74-0.91; cesarean: aOR 0.87, 95% CI 0.69-1.10). There was no change in the proportion of rehospitalization diagnoses between eras.
Conclusions: Short infant LOS was 51% more common in the COVID-19 era, yet infant rehospitalization within a week did not increase. This natural experiment suggests shorter birth hospitalization LOS among family- and clinician-selected, healthy term infants may be safe with respect to infant rehospitalization, although examination of additional outcomes is needed.