Maternal satisfaction with reduced postnatal length of stay in Brussels: evidence from the KOZI&Home program

Amber Stas; Maria Breugelmans; Lynn Geerinck; An Spinnoy; Sven Van Laere; Leonardo Gucciardo; Monika Laubach; Gilles Faron; Katrien Beeckman

doi:10.1186/s12884-023-05740-0

Maternal satisfaction with reduced postnatal length of stay in Brussels: evidence from the KOZI&Home program

BMC Pregnancy Childbirth. 2023 Jun 26;23(1):475. doi: 10.1186/s12884-023-05740-0.

Authors

Amber Stas¹, Maria Breugelmans², Lynn Geerinck³, An Spinnoy³, Sven Van Laere⁴, Leonardo Gucciardo², Monika Laubach², Gilles Faron², Katrien Beeckman^{5

6}

Affiliations

¹ Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium. amber.stas@vub.be.
² Departement of Obstetrics and Prenatal Medicine, Universitair Ziekenhuis Brussel, Brussels, Belgium.
³ Maternity Ward UZ, Brussels, Belgium.
⁴ Interfaculty Center Data Processing & Statistics, Universitair Ziekenhuis Brussel, Brussels, Belgium.
⁵ Nursing and Midwifery, Centre for Research and Innovation in Care, Midwifery Research Education and Policymaking, Universiteit Antwerpen, Antwerp, Belgium.
⁶ Department of public health, Nursing and Midwifery Research Group, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.

Abstract

Background: Reducing the length of stay (LOS) after childbirth is a trend, including cost savings, a more family-centered approach and lower risk for nosocomial infection. Evaluating the impact of reduced LOS is important to improve the outcomes of care, which include maternal satisfaction. The aim of this study was to compare the maternal satisfaction, before and after the reduced LOS.

Methods: This study was conducted in the University Hospital Brussels, before and after implementing the KOZI&Home program (intervention). This KOZI&Home program consisted of a reduced length of stay of at least one day for both vaginal delivery and caesarean section. It also included three extra antenatal visits with the midwife, preparing for discharge and postnatal home care by an independent midwife. Women completed a questionnaire, including the Maternity Satisfaction Questionnaire (MSQ) and Home Satisfaction Questionnaire (HSQ), respectively at discharge and two weeks postpartum. Satisfaction was split into five dimensions: 'Midwives time investment', 'Provision of information', 'Physical environment', 'Privacy' and 'Readiness for discharge'. A combination of forward and backward model selection (both directions) was used for statistical analysis.

Results: In total, 585 women were included in this study. 332 women in the non-intervention group and 253 women in the intervention group. Satisfaction with 'provision of information' at home had a higher mean score of 4.47/5 in the intervention group versus 4.08/5 in the non-intervention group (p < 0.001). Women in the KOZI&Home group were more satisfied regarding 'privacy at home' (mean 4.74/5 versus 4.48/5) (p < 0.001) and 'readiness for discharge' (p = 0.02).

Conclusion: The intervention was associated with a higher score in some of dimensions of satisfaction. Our study concludes that this integrated care program is acceptable for postpartum women and associated with some favourable outcomes.

Keywords: Early discharge; Integrated care; Length of stay (LOS); Patient satisfaction; Postpartum Period.

MeSH terms

Cesarean Section*
Female
Humans
Length of Stay
Parturition*
Patient Satisfaction
Personal Satisfaction
Postpartum Period
Pregnancy