California Hospitals Discharge Many Newborns in Low-Income Families Early, Study Finds
Hospitals in California discharge many newborns in low-income families earlier than the recommended two days, despite a state law that requires health insurers to cover the cost, according to a study published in the February issue of Pediatrics, the AP/San Diego Union-Tribune reports. California passed the law in 1997, when concerns over "drive-through deliveries" prompted Congress and 43 states to require health insurers to cover physician-ordered two-day hospital stays for newborns and four-day stays for those born by caesarean section; the law does not mandate minimum hospital stays (AP/San Diego Union-Tribune, 2/3). The study, conducted by researchers at the University of California-San Francisco, examined a 1999 postpartum survey of 2,828 newborns considered at low risk for complications and their mothers, most of whom had health insurance (Frisch, Reuters Health, 2/3). The study found that the hospitals discharged more than 49% of women and their newborns earlier than recommended (Pritchard, AP/Contra Costa Times, 2/3). Hospitals were more likely to discharge women and their newborns early when the women were Latina, had incomes less than or equal to 400% of the federal poverty level or were covered by Medicaid, the study found (Galbraith et al., Pediatrics, February 2003). The study also found that 68% of the women and their newborns did not receive adequate care after their discharge, which could lead to complications from jaundice, dehydration or other conditions in a newborn's third or fourth day.
The study did not conclude that hospitals or health insurers have violated the 1997 state law, but "there appears to be a gap between what's available by law and what gets done in hospitals and clinics," the AP/Union-Tribune reports. "We created a policy that might not be protecting socioeconomically disadvantaged infants in the same way," Dr. Alison Galbraith, lead author of the study, said, adding, "The law was designed to promote longer length of stay and follow-up for babies that did go home early. But that's not really happening." The authors of the study "suggest that financial pressures are conspiring to limit care," the AP/Union-Tribune reports. However, Steven Thompson, a vice president at the California Medical Association, said that women and their newborns should leave the hospital as early as they can to rest at home. "There's nothing whatsoever medically inappropriate with a short length of stay following birth," he said (AP/San Diego Union-Tribune, 2/3). The study is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.