The purpose of this study is to test an early discharge model of care for preterm infants. It is hypothesized that a multidisciplinary approach, utilizing hospital, homecare company, and third party payor expertise and resources, would permit safe and effective earlier discharge of premature infants. We report the first 50 infants enrolled in a randomized clinical trial for discharge of infants born at < 1800 gms, < 36 wks gestation at several hospitals. Infants are randomized to discharge at 1750-1850 grams(study) or traditional ( 2000 grmas). Both groups receive nursing and neonatologist care, cardiorespiratory monitoring, support for medication, nasogastric feeds, thermoregulation, etc. To date, 40% of eligible infants have been enrolled. Groups are compared for birth (BW, kg) and discharge weights (DW, kg), length of hospital stay (LOS, days), home nursing service duration (NUR), weight gain from 1.8 - 2.0 kg, (gms/day), home weight gain/day(WG, kg), and homecare cost (O$). Mean data are: Table Hospital charges saved on the study group were a mean of $9,000/infant. Five study infants were discharged on nasogastric feeds. Two study infant required rehospitalization (fever, anemia) at >2100 gms. These data suggest that a comprehensive approach to discharge and home care can permit the earlier discharge of premature infants that is safe, beneficial to the infant, and reduces cost. Funded by Keystone Health Plan East, Paidos Healthcare and Jeff Med Col.

Table 1