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The timing of hospital discharge should be the decision of the health care provider caring for the mother and newborn infant and should not be based on arbitrary policies established by third-party payers, according to a new policy statement released by the AAP s Committee on Fetus and Newborn. “A shortened hospital stay (less than 48 hours after delivery) for healthy term newborns can be accommodated but is not appropriate for every mother and newborn,” William E. Benitz, MD, FAAP, and colleagues wrote in the statement. Newborns discharged from the hospital before 48 hours after delivery should have a scheduled appointment with a health care practitioner within 48 hours of discharge. If an appointment cannot be scheduled, hospital discharge should be deferred until a mechanism for follow-up is identified, according to the statement. The committee encourages institutions to develop processes to prevent the necessity for early discharge of uninsured or underinsured newborn infants for strictly financial reasons. It is recommended for institutions to establish guidelines through their professional staff, appropriate community agencies as well as state and local public health agencies to create hospital-stay programs for mothers and newborn infants. Regarding obstetrical, newborn nursery and follow-up care, the committee recommends considering these as independent services and should be paid separate from a global fee for maternity-newborn labor and delivery services. “Adoption of standardized processes, such as predischarge checklists, may facilitate more uniform implementation of these recommendations across the full spectrum of health care settings where care for newborn infants is provided,” the committee members wrote.
Author: Benitz WE, et al., Pediatrics