Reuters Health Information (2004-10-07): Postpartum home nursing visits cost-effective for preventing hospital care
Postpartum home nursing visits cost-effective for preventing hospital care
Last Updated: 2004-10-07 15:13:57 -0400 (Reuters Health)
NEW YORK (Reuters Health) - A home nursing visit a few
days after delivery is a cost-effective way to prevent hospital care
for neonatal jaundice and dehydration, according to a report in the
October issue of Pediatrics.
"The third or fourth day after delivery is the time when babies can
get into trouble with jaundice and dehydration and the American Academy
of Pediatrics and other groups recommend follow-up on these days," lead
author Dr. Ian Paul, from Penn State Children's Hospital in Hershey,
Pennsylvania, told Reuters Health.
However, the reality is that infants are often not seen on these
days, either "because the pediatrician is unaware of the
recommendations, their office is too busy to squeeze in more babies on
the appropriate day, or simply because the office is closed," Dr. Paul
"People have been talking about home nursing visits as a way to
improve follow-up," Dr. Paul noted, "but few studies have looked at
whether such visits improve health outcomes and whether they are cost
To investigate, the researchers analyzed data from all neonates who
were born at the Hershey Medical Center between 2000 and 2002. A total
of 2967 infants were identified, including 326 who received a home
nurse visit and 2641 who did not.
The rate of hospital readmission for jaundice/dehydration in the
first 10 days of life was 2.8% for the non-nurse group compared with
just 0.6% for the nurse group. The corresponding rates for an ER visit
in the first 10 days of life were 3.5% and 0%.
The average cost per child in the non-nurse group was $118.70
compared with $109.80 per child in the nurse group. The cost benefit of
the nurse visit strategy is due to the avoidance of an ER visit and
hospital admission; while a home nurse visit costs insurers about $85,
an ER visit and hospital admission typically cost around $400 and
$4000, respectively, the investigators note.
"A home nurse visit provides a bridge over the gap between nursery
care and primary care," Dr. Paul said. "Such visits are already
standard of care in England, many areas of Canada, and several other
Still, given the retrospective nature of the current study, Dr. Paul
believes a prospective study is warranted to verify the
cost-effectiveness of this approach.