December 17, 1997

Early Discharge of Newborns-Reply

Author Affiliations

University of Washington Seattle
University of North Carolina Chapel Hill

JAMA. 1997;278(23):2066. doi:10.1001/jama.1997.03550230042031

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In Reply  —Drs Cass and Volk suggest that an NNT analysis is a necessary adjunct to the interpretation of our study. While we agree that this provides valuable information to physicians, health care organizations, and policymakers, interpretation of NNT results will also vary depending on one's viewpoint (patient, provider, or payer) and the outcome in question. With regard to inclusion of the intermediate discharge group, we elected not to include this group because their LOS overlapped with both early- and late-discharge groups. Given this misclassification, an estimate of the effect of "intermediate" discharge would be misleading. Cass and Volk are correct in pointing out the increased risk among newborns discharged the day following birth but within 24 hours. We believe that this highlights the importance of careful evaluation of newborns born late in the day who are discharged early the next morning. Furthermore, it illustrates the necessity of expanding the definition of