"The Heart of the Matter"

brought to you by NEMA - The National Emergency Medicine Assoc.

Return to Topic List

Week: 521.5 Guests: Ken Bancroft and Howard Birenbaum, M.D. Topic: Length of Hospital Maternity Stay Issue Host: Steve Girard Producer: Ed Graham

NEMA: How long was your mother in the hospital after you were born? Mine? Four days. Today, things are much different. Today, we're at St. Agnes Hospital in Baltimore, MD...to talk about how administration, staff and patient concerns drove the hospital to make a dramatic statement on maternity and natal stays...Ken Bancroft is the Senior Vice President of Health System development...Dr. Howard Birenbaum is the Director of Neonatology. Dr.....give me some background on this story....

Birenbaum: Those of us who have been involved in the care of newborn babies in particular have been concerned about a trend towards earlier and earlier discharge, from what used to be a stay of three or four days down to two days, one day, and then talk of potentially going to a 12 hour length of stay. There were concerns about the safety of a practice of earlier and earlier discharges that was not adequately tested.

NEMA: Lawmakers tried to remedy the situation?...

Birenbaum: There was legislation that was passed last year that established a 48 hour minimum length of stay. This did not in effect, become reality as the majority of mothers and babies were being discharged at 24 hours because there was a loophole in the law that allowed for earlier discharge if the mothers and babies were deemed stable.

NEMA: Dr....was there a lot insurance company pressure to keep maternity stays short?.....

Birenbaum: I think physicians felt that they were helpless in the current environment...in which they were being profiled by insurance companies as to what their length of stay was. They were being monitored with respect for advocating for their patients, both on the maternal side and the pediatric side. There's also concern that physicians' expressed with respect to their ability to maintain privileges at hospitals if lengths of stay were exceeded.

NEMA: Mr. Bancroft, what did the St. Agnes administration decide to do?....

Bancroft: No woman should be denied the ability to stay in the hospital after a newborn birth for 48 hours, and we offered to pick up the cost of that second day to remove that concern and burden from either the mothers and the insurance so the mother and the infant could stay for two days, the insurance company would only be paid for the first day.

NEMA: That has to have a big financial impact on the hospital...

Bancroft: We estimated the initial cost of this per year was about 500 thousand dollars. It was our way of giving back to the community. We have been a strong hospital financially and quite often we look for ways to give back and this was one way to help at a time when many physicians and many mothers felt trapped and helpless in the system...that they knew what was required of them wasn't right , but there wasn't a whole lot they could do about it. This was our way of taking a stand on an important health issue that affected a lot of people in our community.

NEMA: What's the feedback been like?....

Bancroft: The support that we've gotten from the community has been overwhelming. We've gotten phone call, letters, comments from patients and family. 80% of the mothers who had babies at St. Agnes since that time that were eligible for the program have stayed for the two days...other ones, for various personal reasons chose not to do it, but a majority of mothers have taken advantage of it.

NEMA: The Maryland legislature has again passed a bill which mandates maternity and natal stays of at least 48 hours, unless the mother wants to leave early...and provides for better coordination between Doctors, hospital administration and insurance companies. It takes effect this summer. I'm SG.

Send mail to info@nemahealth.org
Copyright © 1996 National Emergency Medicine Associations, Inc.
Last modified: November 04, 2021