The length of stay (LoS) in hospitals after childbirth is a critical factor in healthcare delivery, impacting both maternal and neonatal outcomes as well as healthcare costs. A recent study conducted in the Friuli Venezia Giulia (FVG) region of North-Eastern Italy from 2005 to 2015 provides valuable insights into the determinants of LoS following vaginal deliveries (VD), offering practitioners an opportunity to refine their practices and policies.
Study Overview
The study analyzed data from 12 maternity services in FVG, focusing on spontaneous vaginal deliveries (SVD) and instrumental vaginal deliveries (IVD). The average LoS was found to be 2.9 days for SVD and 3.3 days for IVD. The research aimed to identify factors influencing LoS and proposed benchmarks for early discharge (ED): 2 days post-SVD and 3 days post-IVD.
Key Determinants of Length of Stay
The study identified several factors influencing LoS:
- Maternity Centers: Hospital practices were the most significant determinant of LoS. Variability across hospitals suggested that standardization could reduce unnecessary extended stays.
- Maternal Health Factors: Conditions such as hypertension, diabetes, and eclampsia/pre-eclampsia were associated with longer stays.
- Newborn Clinical Factors: Gestational age, birth weight, and Apgar scores influenced LoS. Late pre-term infants had longer stays due to increased morbidity risks.
- Socio-Demographic Factors: Non-EU nationality and socio-economic status also played roles in determining LoS.
Implications for Practice
The findings highlight the need for standardized discharge policies across hospitals to ensure consistent care quality and efficiency. Practitioners should consider these determinants when planning discharge to balance safety with resource optimization.
Strategies for Improvement
- Standardized Guidelines: Implementing uniform discharge guidelines can help reduce variability in LoS across different maternity centers.
- Enhanced Primary Care Services: Strengthening follow-up care for early discharged mothers can improve outcomes and reduce readmissions.
- Cultural Preparation: Educating healthcare providers and patients about the benefits of ED can facilitate smoother transitions from hospital to home.
Encouraging Further Research
The study underscores the importance of continuous research to refine obstetric care practices. Practitioners are encouraged to explore further research on the impact of ED on maternal and neonatal health outcomes.
To read the original research paper, please follow this link: Determinants of Length of Stay After Vaginal Deliveries in the Friuli Venezia Giulia Region (North-Eastern Italy), 2005–2015.
