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Commentary on the papers by Oddie et al (see page 119) and Escobar et al (see page 125)
Two papers coincidentally submitted to Archives from opposite sides of the Atlantic give an opportunity to point out some interesting similarities and differences in the controversial area of hospital readmission shortly after birth. Clinicians in both the UK and the USA are concerned about the knock-on effects of the increasing trend towards earlier neonatal discharge from hospital.
The studies differ significantly in their objectives and methods, so direct numerical comparisons may not be valid. Oddie et al looked at over 11 000 births in the Northern NHS region of the UK in 1998, excluding infants less than 35 weeks gestation.1 They concentrated on factors associated with early neonatal discharge, and then looked at what influenced readmission to hospital within 28 days. Escobar et al studied a population of over 33 000 using the Kaiser Permanente Medical Care Program (KPMCP) in California and Colorado, for which good data are available, in 1998–2000;2 they included all gestations and did not look at early discharge at all, but analysed in some detail factors associated with readmission within two weeks. The KPMCP, although not government run, is a managed healthcare system which has been described as being …
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