Postpartum readmission rates increase
Readmission was more common among publically insured, black patients presenting with comorbidities including hypertension and diabetes.
HealthDay News — Postpartum readmission rates rose from 2004 to 2011, according to a study published in the July issue of the American Journal of Obstetrics & Gynecology.
Mark A. Clapp, MD, MPH, from Brigham and Women's Hospital in Boston, and colleagues used State Inpatient Databases to evaluate 114,748 postpartum readmissions out of 5,949,739 eligible deliveries occurring within the first 6 weeks after delivery in California, Florida, and New York (between 2004 and 2011).
The researchers found that the readmission rate increased from 1.72% in 2004 to 2.16% in 2011. Readmission was more likely among patients who were publicly insured, black, had comorbidities such as hypertension and diabetes, and had a cesarean delivery. Common indications for readmission included infection (15.5%), hypertension (9.3%), and psychiatric illness (7.7%). On average, patients were readmitted 7 days after discharge, but this varied by diagnosis: day 3 for hypertension, day 5 for infection, and day 9 for psychiatric disease. Comorbidities (psychiatric disease, substance use, seizure disorder, hypertension, and tobacco use) were the strongest predictors of postpartum readmissions.
"Understanding the risk factors, etiologies, and cause-specific timing for postpartum readmissions may aid in the development of new quality metrics in obstetrics and targeted strategies to curb the rising rate of postpartum readmissions in the United States," conclude the authors.
- Clapp MA, Little SE, Zheng J, Robinson JN. A multi-state analysis of postpartum readmissions in the United States. Am J Obstet Gynecol. 2016;215(1):113.e1-113.e10; doi: 10.1016/j.ajog.2016.01.174