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Short hospital stays after births are not inherently harmful to women and newborns, a recent study concludes.

One-day hospital stays after vaginal births and two-day hospital stays after Caesarean section births do not cause higher readmission rates for either mothers or babies than longer hospital stays, according to the study by Seattle-based consulting firm Milliman & Robertson Inc.

Milliman & Robertson reached this conclusion by examining data provided by HCIA Inc., a Baltimore-based health care information company, covering hospital discharges for 590,000 women and 1.4 million newborns during 1993. The information was compiled from several databases.

The study's findings run counter to a widespread public backlash against short maternity stays imposed by managed care plans. State legislators in recent years have passed laws mandating minimum inpatient stays after birth, typically 48 hours after vaginal deliveries and 96 hours after Caesarean-section births.

In its health care management guidelines, Milliman & Robertson recommends a 24-hour post-delivery hospital stay for normal vaginal births and a 48-hour post-operative stay for Caesarean-section births.

"This outcomes study supports our continued contention that our suggested hospital stays for both normal vaginal delivery and Caesarean section represent quality health care treatment," said Dr. Frederick W. Spong, a health care consultant and one of the authors of the study. "In fact, the readmission rate for patients who spend only one day in the hospital is marginally less for both mother and child than for those who stay longer after a normal vaginal delivery.

"Because one out of seven hospital admissions is for maternity, the cost implications of lengthier hospital stays are profound," Dr. Spong said.

Maternity hospital stays vary widely across the country, according to the study, which was released last month.

For example, though nationally an average of 34% of women with normal vaginal births stayed in the hospital only one day in 1993, some 72% of women with normal vaginal births stayed in the hospital one day in the West. In the South, 38% of women stayed in the hospital one day after a vaginal delivery that year and 31% of women stayed in the hospital one day in the Midwest. Only 9% of women with normal vaginal births stayed in the hospital only one day afterward in the Northeast, the study found.

Free copies of the report, "Inpatient Care for Mothers and Newborns," are available from Deanna Ashley, Milliman & Robertson Inc., 8910 University Center Lane, Suite 425, San Diego, Calif. 92122; 619-558-8400.

Pension change

PITTSBURGH-An agreement between members of the United Steelworkers of America and Wheeling-Pittsburgh Corp. will resolve a pension dispute that has kept union workers on strike since late 1996.

Wheeling-Pittsburgh and union members earlier this month agreed to a new contract under which the steelmaker will convert its 12-year-old defined contribution plan to a defined benefit plan.

Workers will receive a $2,000 bonus for signing the contract.

Under the new contract, the defined benefit pension plan will give retirees monthly payments amounting to $40 for each year of service, increasing to $44 per year of service on June 1, 2003. The contract also calls for a wage increase of $1.50 an hour.

Union workers last year balked at the employer's proposal to enhance defined contribution plan benefits, calling for a defined benefit pension plan instead. The workers had been on strike since Oct. 1, 1996 (BI, Oct. 21, 1996).

Since 1985, when Wheeling-Pittsburgh declared bankruptcy, workers have had a defined contribution pension plan, according to a union spokesman. Before the bankruptcy proceeding, workers had a different defined benefit pension plan, he said. Wheeling-Pittsburgh reorganized about five years ago, the spokesman said.

Wheeling-Pittsburgh also is offering about 850 workers incentives to retire early. These workers may retire early and receive either a $25,000 lump-sum payment or a $400 per month pension supplement until age 62, in addition to their regular pension benefits.

Wheeling-Pittsburgh agreed to establish a $2 million fund to reimburse workers or pay for some covered medical expenses during the 10-month strike, excluding insurance costs. Details on this fund and what it will cover have not been finalized, the spokesman said.

Partner benefits

ENGLEWOOD, Colo.-US WEST Inc. will offer full health care benefits to the same-sex domestic partners of all employees as well as their eligible dependents.

Extending medical, dental and vision benefits will help the $13 billion communications company attract and retain qualified employees in today's diverse workforce, said Toni Ozeroff, vp-law and corporate human resources for the Englewood, Colo.-based telecommunications company.

Yet, US WEST anticipates that the expanded coverage, which takes effect Jan. 1, will have only a "minimal" impact on the cost and effort of providing benefits to the eligible domestic partners and dependents of its 69,000 employees, she said. More specific cost estimates are not available, a company spokesman said.

US WEST's employees will have the opportunity to sign up same-sex domestic partners and eligible dependents for full benefits during the company's annual open enrollment period, Oct. 1 to Oct. 31. Enrollment in the new program requires employees to complete an affidavit confirming that their relationship is long-term, "essentially the equivalent of marriage," the company said in a statement.

Health care benefits will not be extended to unmarried opposite-sex partners of US WEST employees because they have the option of becoming eligible through legal marriage, the company said in a statement.