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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica


IMPACT FACTOR 2018: 1.361
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1619-3997
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Volume 47, Issue 8

Issues

Protocols for early discharging of premature infants: an empirical assessment on safety and savings

Chiara Daicampi / Rosanna I. Comoretto
  • Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121 Padova, Italy
  • Other articles by this author:
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/ Nicola Soriani
  • Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121 Padova, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Elisabetta Lolli / Stefania Boschetto
  • Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121 Padova, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Micol Cecchin
  • Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121 Padova, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Anna Marinetto / Eva Pagano / Egle Perissinotto
  • Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121 Padova, Italy
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Eugenio Baraldi / Dario Gregori
  • Corresponding author
  • Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121 Padova, Italy
  • Email
  • Other articles by this author:
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Published Online: 2019-08-17 | DOI: https://doi.org/10.1515/jpm-2018-0420

Abstract

Background

Preterm newborns may be discharged when clinical conditions are stable. Several criteria for early discharge have been proposed in the literature. This study carried out the first quantitative comparison of their impact in terms of hospitalization savings, safety and costs.

Methods

This study was based on the clinical histories of 213 premature infants born in the Neonatal Intensive Care Unit of Padova University Hospital between 2013 and 2014. Seventeen early discharge criteria were drawn from the literature and retrospectively applied to these data, and computation of hospitalization savings, safety and costs implied by each criterion was carried out.

Results

Among the criteria considered, average gains ranged from 1.1 to 10.3 hospital days and between 0.3 and 1.1 fewer infections per discharged infant. Criteria that led to saving more hospital days had higher cost-effectiveness in terms of crisis and infection, and they spared infants from more infections. However, episodes of apnea and bradycardia were detected after the potential early discharge date for all criteria, with a mean number of episodes numbering between 0.3 and 1.4.

Conclusion

The results highlight a clear trade-off between days saved and health risks for infants, with potential consequences for health care costs.

Keywords: cost-effectiveness; criteria for discharge; early discharge infants; safety

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About the article

Corresponding author: Prof. Dario Gregori, MA, PhD, Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121 Padova, Italy, Tel.: +390498275384, Fax: +39 02 700445089


Received: 2018-12-14

Accepted: 2019-07-26

Published Online: 2019-08-17

Published in Print: 2019-10-25


Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Journal of Perinatal Medicine, Volume 47, Issue 8, Pages 885–893, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/jpm-2018-0420.

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