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To the editor:Having been educated with a scientific academic background prior to joining the insurance professional amalgam, I am often surprised at how quickly people accept what "studies" attempt to "prove."
Your Aug. 25 article "Study Finds Short Maternity Stays Not Harmful" and editorial "Speak Up, Managed Care" are two such examples.
One of the first things you learn as you embark on a scientific academic education is that "outcomes" or retrospective studies (studies that look back at already-established data) are inherently flawed. No one has ever completed a retrospective study and compensated for all variables, because you can not know all possible variables at any given time.
The maternity readmission rate for mothers and babies who voluntarily stay 24 hours, by any logical sense, should be lower than those who stay longer. Most mothers would not leave the hospital voluntarily at 24 hours if they were not the type of person to bounce back from the procedure quickly. You already have deselected those mothers who by personality traits alone need the longer stay. Also, those who fall into the latter category would, by all logical sense, exhibit a higher readmission rate due solely to their personality traits and ability or inability to handle pain and stress.
Now let's consider those who have a difficult delivery with complications. They invariably would stay longer and also exhibit a higher incidence of readmission. The only way to quantify the true impact the shorter stay has on the readmission rates would be to force all maternity stays in a random, double blind, infinite stay control group. The liability issues created by forcing the first group out at 24 hours would prevent this study from ever being performed, yet the managed care companies would like us to believe their data is complete and their study valid.
The statement that "the outcomes study supports our continued contention that our suggested hospital stays for both normal vaginal delivery and Caesarean section represents quality health care treatment" only furthers the old adage that a little knowledge can be a dangerous thing. I think Dr. Frederick W. Spong should review his basic scientific guidelines on valid experimental techniques prior to performing his next "health care study."
My wife delivered our son Seamus on Feb. 18, 1997, and was lucky enough to have been able to walk out the next day. She had an extremely good outcome and is a tough character. I can tell you that knowing she could stay longer was a definite factor in her leaving early (just another unknown variable).
Old Orchard Beach, Maine