Maternity Care:

Appropriate Follow-Up Services Critical With Short Hospital Stays

HEHS-96-207: Published: Sep 11, 1996. Publicly Released: Sep 11, 1996.

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Pursuant to a congressional request, GAO reviewed issues surrounding shortened postpartum hospital stays, focusing on: (1) the risks that are attributable to short hospital stays for maternity care; (2) health plan actions to ensure quality postpartum care for short-stay newborns; and (3) state responses to concerns about patient protection.

GAO found that: (1) many medical personnel are concerned that early hospital discharges for newborns delay detection of serious disorders that are not apparent in the first 24 hours after birth; (2) 24 hours may not be long enough to assess a new mother's abilities and readiness to take care of her newborn child; (3) studies have not shown a definitive correlation between early discharges and increased hospital readmissions of newborns, but many of the studies' methodologies are seriously flawed; (4) medical experts agree that the quality of maternity care is more important than the length of hospitals stays and that a full range of prenatal, delivery, and postpartum services should be provided; (5) some hospitals and health care plans with early discharge policies have developed programs to ensure that maternity patients receive quality services such as prenatal assessment and education, flexibility that allows physicians to make discharge decisions, and direct, professional follow-up care within 72 hours of discharge; (6) other plans may not provide all of these recommended services and their follow-up care may consist only of a telephone hotline number; (7) 30 states have enacted laws or regulations that require insurers to cover minimum maternity stays, but these efforts vary in scope; (8) self-funded employer insurance plans, and some state Medicaid and employee plans are not subject to these state regulations; (9) applicability questions also arise for those employees who live and work in different states; and (10) Congress is considering legislation to make maternity care more consistent and available to all privately insured women.

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