A randomized trial of early discharge and nurse specialist transitional follow-up care of high-risk childbearing women

Nurs Res. 1997 Sep-Oct;46(5):254-61. doi: 10.1097/00006199-199709000-00003.

Abstract

In a randomized clinical trial, quality of health care as reflected in patient outcomes and cost of health care was compared between two groups of high-risk childbearing women: women diagnosed with diabetes or hypertension in pregnancy. The control group (N = 52) was discharged routinely from the hospital. The intervention group (N = 44) was discharged early using a model of clinical nurse specialist transitional follow-up care. During pregnancy, the intervention group had significantly fewer rehospitalizations than the control group. For infants of diabetic women enrolled in the study during their pregnancy, low birth weight (< or = 2,500 g) was three times more prevalent in the control group (29%) than in the intervention group (8.3%). The postpartum hospital charges for the intervention group were also significantly less than for the control group. The mean total hospital charges for the intervention group were 44% less than for the control group. The mean cost of the clinical specialist follow-up care was 2% of the total hospital charges for the control group. A net savings of $13,327 was realized for each mother-infant dyad discharged early from the hospital.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aftercare* / economics
  • Female
  • Health Care Costs
  • Home Care Services / organization & administration
  • Hospitalization / economics
  • Humans
  • Hypertension / nursing
  • Infant, Newborn
  • Maternal-Child Nursing* / economics
  • Nurse Clinicians / organization & administration*
  • Patient Discharge*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / nursing
  • Pregnancy Outcome
  • Pregnancy in Diabetics / nursing
  • Pregnancy, High-Risk*
  • Time Factors
  • Treatment Outcome