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Researchers examine correlation between length of stay following childbirth and women's satisfaction with care

Efforts to reduce hospital stays and lower costs led to the phenomenon known as "drive-through deliveries," that is, the practice of discharging women from the hospital within 24 hours of giving birth. This practice prompted 1996 legislation requiring that insurers cover a postpartum length of stay of up to 48 hours for an uncomplicated delivery.

A recent study shows that a woman's perception of the adequacy of her hospital stay—not the actual length of the stay—affects her satisfaction with care. In this study, women who perceived their hospital stays for birth as "too short" were less satisfied with six aspects of care than those who did not. Yet differences in satisfaction according to actual length of stay were small and of questionable practical significance, explains Beth S. Finkelstein, Ph.D.

In a study supported in part by the Agency for Health Care Policy and Research (National Research Service Award training grant T32 HS00059), the researchers administered a postdischarge survey to 15,000 women admitted for labor and delivery to 18 hospitals over a 3-year period. The women were asked to evaluate their hospital stays in terms of physician care, nursing care, provision of information, preparation for discharge, overall assessment of care, and willingness to return to the same hospital. Among women with vaginal deliveries, 70 percent felt that their stay was just right. Women with 1-day stays were less likely to feel it was just right and more apt to feel their stay was too short than women who stayed for 2 or more days (57 percent vs. 76 percent and 39 percent vs. 16 percent, respectively).

Women who stayed in the hospital for 2 or 3 days following cesarean delivery were less apt to feel that their stay was just right and more likely to feel that their stay was too short than women who stayed 4 or more days after a c-section (69 percent vs. 75 percent and 26 percent vs. 11 percent, respectively). Satisfaction scores were higher for patients who felt that their stay was just right and lower among those who perceived it was too short or too long. In contrast, mean satisfaction scores according to actual length of stay were much lower.

See "Does length of hospital stay during labor and delivery influence patient satisfaction? Results from a regional study," by Dr. Finkelstein, Dwain L. Harper, D.A., and Gary E. Rosenthal, M.D., in the American Journal of Managed Care 4(12), pp. 1701-1708, 1998.

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