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Postpartum readmissions increased from 2004 to 2011

The rate of postpartum readmissions increased nearly 0.5% during the course of 7 years, according to data presented at the Annual Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists.

Mark A. Clapp, MD, MPH, in the Department of Obstetrics and Gynecology at Brigham and Women’s Hospital in Boston, stressed the importance of determining indications for readmission in order to deliver effective care and interventions. Researchers calculated readmission rates in California, Florida and New York for patients who were readmitted within 6 weeks after delivery between 2004 and 2011. They also investigated characteristics and predictors of readmission.

Results showed the readmission rate increased from 1.72% to 2.16% between 2004 and 2011. Clapp and colleagues found patients who were readmitted were more likely to have had a cesarean delivery (37.2% vs. 32.9%; P < 0.001), be publicly insured (54.3% vs. 42%; P < 0.001), have comorbidities and be black (18.7% vs. 13.5%; P < 0.001).

In addition, the most common indications for readmission were psychiatric illness (7.7%), hypertension (9.3%) and infection (15.5%). Researchers identified that diagnosis dictated the day of readmission: Patients were readmitted on day 9 for psychiatric illness, day 3 for hypertension and day 5 for infection.

They also found the strongest predictors of postpartum readmissions were maternal comorbidities, which included psychiatric disease (OR = 2.54; 95% CI, 2.45-2.6), substance use (OR = 2.02; 95% CI, 1.96-2.08), seizure disorder (OR = 1.99; 95% CI, 1.87-2.11), hypertension (OR = 1.89; 95% CI, 1.84-1.93) and tobacco use (OR = 1.86; 95% CI, 1.8-1.92).

They concluded, “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.” – by Chelsea Frajerman Pardes

Reference:

Clapp MA, et al. Transitioning women from obstetric care to primary care: A missed opportunity. Presented at: the Annual Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists; May 14-17, 2016; Washington, D.C.

Disclosure: The researchers report no relevant financial disclosures.