An evaluation of the rate and severity of readmissions for jaundice or dehydration associated with shorter neonatal hospital stay

Objective. A recent rapid decrease in the length of neonatal hospital stay in Ontario allowed a study of the association between age at hospital discharge of healthy newborn infants and subsequent readmission rates.;Study design. (a) A population-based study of a total of 920,554 healthy newborn infants in Ontario from 1987 to 1994, and (b) a single hospital-based retrospective study of infants readmitted from home to the Hospital for Sick Children (HSC) for jaundice or dehydration.;Results. In Ontario, the readmission rate during the first two weeks of life increased from 12.9 to 20.7 per 1,000 (p = 0.000), especially for jaundice or dehydration, during a time-period when length of neonatal hospital stay decreased from 4.5 to 2.7 days (p = 0.000). The infants readmitted to HSC after shorter neonatal hospital stay showed evidence of increased severity of illness as indicated by higher serum bilirubin and sodium concentrations.;Conclusions. The increased readmission rate in Ontario and the increased severity of jaundice and dehydration in readmitted infants to HSC raise the question whether shorter hospital stay of apparently healthy newborn infants is always safe. Decisions regarding the timing of neonatal discharge and appropriate follow-up should be based upon a thorough assessment of the individual infant and his/her supports.