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To evaluate the outcome of an early discharge program regarding the length of stay, hospital expense, maternal satisfaction, and patient safety in a military population. Data from MAMC was analyzed over two six-month periods from March - August 1994 (before early discharge) and March - August 1995 (after early discharge). Strict criteria established by the American Academy of Pediatrics were used to assure patient safety. Each mother received education regarding maternal and infant care, and telephone follow-up at 48 hours and five days after discharge. Principal outcome measures included length of hospital stay, inpatient cost, maternal and infant health services utilization, and maternal satisfaction. Maternal and infant health services utilization information was obtained by hospital record review over the study period. Maternal satisfaction was measured by survey. During the study period, a total of 2,236 deliveries was examined. The mean hospital days were 2.54 (SD = 0.83) per infant in 1994 compared with 2.10 (SD= 1.01) in 1995. The program was able to save 561 inpatient hospital days for a total cost savings of $399, 166.00. This reduction in hospital days netted an average cost savings of $335.31 per infant. For the six-month study period in 1994, there was a total of nine readmissions out of 1,042 deliveries, and in 1995 there were sixteen readmissions out of 1,194 deliveries. By comparing the data, there was no significant increase in the number of readmissions between the 1994 group (0.86%) and the 1995 group (1.34%) [OR = 1.56, 95% CI: 0.69, 3.54]. For each group, the majority of readmissions were for sepsis rule-out and hyperbilirubinemia. Most of the telephone follow-up and primary care visits were attributed to feeding and infant care concerns. Additionally, a survey showed maternal satisfaction was good with an average score of 3.8(out of 5) of those mothers surveyed. By following strict discharge criteria, increasing patient education prior to discharge, implementing a phone follow-up system, and ensuring easy access to care, an early discharge program in our military population was cost effective and not associated with increased adverse maternal and newborn outcomes.

Evaluation of an Early Discharge Program of Mothers and Infants Following Childbirth in a Military Population. 894