The Impact of the COVID-19 Pandemic on Postpartum Readmission Rates at a Single Tertiary Care Center in New York City

Abstract

Objective The aim of this study was to mitigate transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and decrease exposure to the hospital setting, Mount Sinai Hospital implemented new protocols, including early postpartum discharge. Early discharge would allow for more single-bedded rooms, limiting exposure to other patients and their support persons. During the pandemic, patients were discharged to home on postpartum day 1 or 2 after vaginal or cesarean delivery, respectively, instead of day 2 or 3, unless longer hospitalization was needed for medical indications. We aim to determine if the readmission rate was increased in the setting of earlier discharge during the coronavirus disease 2019 (COVID-19) pandemic.

Study Design Historical cohort study comparing the readmission rate in SARS-CoV-2 negative women who presented to Mount Sinai Hospital for delivery admission from March to May 2019 versus March to May 2020. The primary outcome was readmission rate within 6 weeks of discharge day. Maternal and neonatal characteristics and outcomes were compared between groups using t-tests or Wilcoxon's rank-sum test for continuous measures and chi-squared or Fisher's exact tests for categorical measures, as appropriate. Primary and secondary outcomes were assessed using linear and logistic univariable and multivariable regression.

Results Patients in the 2020 cohort (n = 1,078) were significantly less likely to have public/state insurance (p = 0.02), more likely to have pregestational diabetes (p = 0.02), gestational diabetes (p = 0.04), gestational hypertension (p < 0.01), and an operative vaginal or cesarean delivery (vs. spontaneous vaginal delivery, p = 0.01) compared with 2019 cohort patients (n = 1,910). Patients in the 2020 cohort were significantly more likely to have an earlier postpartum day of discharge and a shorter median length of stay compared with 2019 cohort patients (both p < 0.01). Despite differences in length of stay, the rate of readmission was similar between the two groups (p = 0.45).

Conclusion During the COVID-19 pandemic, there was no difference in readmission rate despite shorter hospital stays.

Key Points

• Maternal length of stay during COVID-19 was shorter.

• Earlier maternal discharge occurred during COVID-19.

• Shorter maternal postpartum stay did not increase readmission rate.

Keywords

coronavirus disease 2019 - length of stay - pregnancy - readmission - SARS-CoV-2 - postpartum

Publication History

Received: 26 February 2021

Accepted: 14 February 2022

Accepted Manuscript online:
17 February 2022

Article published online:
04 April 2022

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