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Doctors Knock ‘Drive-Through’ Baby Deliveries Ama: Physicians Should Decide When Mothers, Infants Go Home

Insurance industry pressure to limit hospital stays for childbirth to 24 hours came under fire Tuesday from the American Medical Association, which said such decisions should be based on medicine, not money.

“That decision ought not to be relegated to the bean counters,” said Dr. John Nelson, an obstetrician and AMA board member from Salt Lake City.

Insurance companies are increasingly limiting hospital stays to 24 hours for mothers and infants after uncomplicated deliveries. Nelson said that in Utah, some insurers pay mothers $100 or $200 in cash to get out within 24 hours.

At the AMA’s annual policymaking meeting in Chicago, an AMA council said in a report that little is known about the health consequences of discharging mothers and newborns so quickly.

In the absence of definitive data, the AMA council said, “Discharge of mothers and infants should be determined by the clinical judgment of attending physicians and not by economic considerations.”

Nelson said that so-called “drivethrough deliveries” could actually increase costs if they lead to complications.

Maryland recently enacted a law that limits the insurance industry’s ability to reduce hospital stays after childbirth. A similar measure is awaiting Gov. Christine Todd Whitman’s signature in New Jersey.

Richard Coorsh, a spokesman for the Health Insurance Association of America, said managed-care plans allow longer stays if they are medically necessary. He said doctors are unhappy because such plans “have forced doctors to compete on the basis of price for the first time.”


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