缩短产后住院时间:对一家三级妇女医院急诊科就诊情况的影响。

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Australian & New Zealand Journal of Obstetrics & Gynaecology Pub Date : 2024-06-14 DOI:10.1111/ajo.13849
Alaina R Francis, Hannah G Gordon, Samantha Mooney
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引用次数: 0

摘要

目的:过去三十年来,澳大利亚医院的产后住院时间(LOS)有所缩短。虽然缩短住院时间可能会降低产后初期的住院费用,但人们担心这会增加急诊服务、家庭护理人员和初级保健提供者的负担。我们的目的是确定澳大利亚一家三级产科医院最近缩短的住院时间是否会导致产后前六周的产妇和出生后 28 天内的新生儿到急诊科就诊的情况发生变化:我们对澳大利亚一家三级产科医院在四个可比时间段(2019-2022 年)内到急诊科就诊的所有出生不足 28 天的新生儿和产后不足 6 周的产妇进行了横断面队列研究。采用逻辑回归法确定新生儿和产妇产后急诊室就诊时间与出生年份之间的关系:产后 LOS 的降低与急诊室产妇和新生儿就诊率的显著增加有关(几率比 (OR):1.15(95% 置信区间 (CI):1.08-1.23)和 OR:1.11(95% 置信区间 (CI):1.03-1.19))。与 2019 年相比,2022 年每 100 名新生儿中就有 6 名产妇和 3 名新生儿到急诊室接受产后护理。在整个研究期间,孕产妇和新生儿入院人数没有差异:产妇和新生儿急诊室就诊人数的增加与LOS的减少应促使人们重新评估产后实践,并鼓励对院内资源分配和产后教育进行进一步研究。
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Reducing the postpartum length of stay: Implications for emergency department presentations at a tertiary women's hospital.

Aims: Postpartum length of stay (LOS) in Australian hospitals has reduced over the past three decades. Although a reduction in LOS likely reduces hospital costs in the immediate postpartum period, there is concern that this is increasing the burden on emergency services, domiciliary staff and primary care providers. The aims were to determine whether the recent reduction in LOS at an Australian tertiary obstetric hospital resulted in a change in emergency department (ED) presentations by women in the first six weeks postpartum, and newborns within the first 28 days of life.

Methods: We conducted a cross-sectional cohort study of all newborns ≤28 days of age and women ≤6 weeks postpartum who presented to the ED during four comparable time periods (2019-2022) at an Australian tertiary obstetric hospital. Logistic regression was used to determine the relationship between neonatal and maternal postpartum ED presentations and year of birth.

Results: Reduced postpartum LOS was associated with a significant increase in maternal and neonatal presentations to the ED (odds ratio (OR): 1.15 (95% confidence interval (CI): 1.08-1.23), and OR: 1.11 (95% CI: 1.03-1.19), respectively). For every 100 births, an extra six women and three neonates presented to the ED for postpartum care in 2022 compared with 2019. There was no difference in maternal or neonatal admissions throughout the study periods.

Conclusion: The increase in maternal and neonatal ED presentations associated with reduced LOS should prompt reassessment of postnatal practice and encourage further research into allocation of in-hospital resources and postpartum education.

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来源期刊
CiteScore
3.40
自引率
11.80%
发文量
165
审稿时长
4-8 weeks
期刊介绍: The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) is an editorially independent publication owned by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the RANZCOG Research foundation. ANZJOG aims to provide a medium for the publication of original contributions to clinical practice and/or research in all fields of obstetrics and gynaecology and related disciplines. Articles are peer reviewed by clinicians or researchers expert in the field of the submitted work. From time to time the journal will also publish printed abstracts from the RANZCOG Annual Scientific Meeting and meetings of relevant special interest groups, where the accepted abstracts have undergone the journals peer review acceptance process.
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