Early postpartum discharge during the COVID-19 pandemic

E. Bornstein, Zucker School of Medicine at Hofstra/Northwell
M. Gulersen, GME
G. Husk
A. Grunebaum, Zucker School of Medicine at Hofstra/Northwell
M. J. Blitz, Zucker School of Medicine at Hofstra/Northwell
T. J. Rafael, Northwell Health
B. L. Rochelson, Zucker School of Medicine at Hofstra/Northwell
B. Schwartz, Zucker School of Medicine at Hofstra/Northwell
M. Nimaroff, Zucker School of Medicine at Hofstra/Northwell
F. A. Chervenak, Zucker School of Medicine at Hofstra/Northwell

Abstract

© 2020 De Gruyter. All rights reserved. To report our experience with early postpartum discharge to decrease hospital length of stay among low-risk puerperium patients in a large obstetrical service during the COVID-19 pandemic in New York. Retrospective analysis of all uncomplicated postpartum women in seven obstetrical units within a large health system between December 8th, 2019 and June 20th, 2020. Women were stratified into two groups based on date of delivery in relation to the start of the COVID-19 pandemic in New York (Mid-March 2020); those delivering before or during the COVID-19 pandemic. We compared hospital length of stay, defined as time interval from delivery to discharge in hours, between the two groups and correlated it with the number of COVID-19 admissions to our hospitals. Statistical analysis included use of Wilcoxon rank sum test and Chi-squared test with significance defined as p-value<0.05. Of the 11,770 patients included, 5,893 (50.1%) delivered prior to and 5,877 (49.9%) delivered during the COVID-19 pandemic. We detected substantial shortening in postpartum hospital length of stay after vaginal delivery (34 vs. 48 h, p≤0.0001) and cesarean delivery (51 vs. 74 h, p≤0.0001) during the COVID-19 pandemic. We report successful implementation of early postpartum discharge for low-risk patients resulting in a significantly shorter hospital stay during the COVID-19 pandemic in New York. The impact of this strategy on resource utilization, patient satisfaction and adverse outcomes requires further study.