OBJECTIVE: To evaluate a program that provides in-home care to women with pregnancies threatened by preterm delivery (including preterm labor, preterm premature rupture of membranes, and multiple gestation) and women with pregnancy-related hypertension. METHODS: Data from hospital discharge summaries were used to compare birth outcomes and cost of care for women in the in-home program and a cohort of women who received in-hospital antenatal care before the new program. Birth outcomes included data for mothers and infants. The sample included 437 women with threatened preterm delivery (n = 228 in-home, n = 209 in-hospital) and 308 with hypertension (n = 155 in-home, n = 153 in-hospital). The cost per woman included all costs of services for mothers and infants. RESULTS: Women at risk of preterm delivery who received in-home care were half as likely to have their infants in the neonatal intensive care unit more than 48 hours (odds ratio 0.53, 95% confidence interval 0.36, 0.78). On average, their infants weighed more (2732 +/- 716 g versus 2330 +/- 749 g, P <.001) and were 2 weeks older at birth (36.1 +/- 3.1 weeks versus 34.0 +/- 4.0 weeks, P <.001). There was a wide range in the total cost per woman and no significant difference between cohorts. For women with hypertension, there were no significant differences between in-home and in-hospital cohorts in birth outcomes or costs of care per woman. CONCLUSION: The program with current admission criteria, staffing, and guidelines for antenatal hospital admission provides safe care to women at similar cost to that of hospitalization.
OBJECTIVE: To evaluate a program that provides in-home care to women with pregnancies threatened by preterm delivery (including preterm labor, preterm premature rupture of membranes, and multiple gestation) and women with pregnancy-related hypertension. METHODS: Data from hospital discharge summaries were used to compare birth outcomes and cost of care for women in the in-home program and a cohort of women who received in-hospital antenatal care before the new program. Birth outcomes included data for mothers and infants. The sample included 437 women with threatened preterm delivery (n = 228 in-home, n = 209 in-hospital) and 308 with hypertension (n = 155 in-home, n = 153 in-hospital). The cost per woman included all costs of services for mothers and infants. RESULTS:Women at risk of preterm delivery who received in-home care were half as likely to have their infants in the neonatal intensive care unit more than 48 hours (odds ratio 0.53, 95% confidence interval 0.36, 0.78). On average, their infants weighed more (2732 +/- 716 g versus 2330 +/- 749 g, P <.001) and were 2 weeks older at birth (36.1 +/- 3.1 weeks versus 34.0 +/- 4.0 weeks, P <.001). There was a wide range in the total cost per woman and no significant difference between cohorts. For women with hypertension, there were no significant differences between in-home and in-hospital cohorts in birth outcomes or costs of care per woman. CONCLUSION: The program with current admission criteria, staffing, and guidelines for antenatal hospital admission provides safe care to women at similar cost to that of hospitalization.
Authors: Shiliang Liu; Maureen Heaman; Reg Sauve; Robert Liston; Francesca Reyes; Sharon Bartholomew; David Young; Michael S Kramer Journal: Matern Child Health J Date: 2006-11-07
Authors: Elizabeth M Harvey; Donna Strobino; Leslie Sherrod; Mary Catherine Webb; Caroline Anderson; Jennifer Arice White; Robert Atlas Journal: Matern Child Health J Date: 2017-02
Authors: Dorothy Brooten; Joanne M Youngblut; Jean Hannan; Frank Guido-Sanz; Donna Felber Neff; Wannee Deoisres Journal: Pac Rim Int J Nurs Res Thail Date: 2012-04
Authors: Kelly L Morgan; Muhammad A Rahman; Steven Macey; Mark D Atkinson; Rebecca A Hill; Ashrafunnesa Khanom; Shantini Paranjothy; Muhammad Jami Husain; Sinead T Brophy Journal: BMJ Open Date: 2014-02-27 Impact factor: 2.692