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Open Access Implementation, Uptake, and Impact of a Provincial Postpartum Program Mise en œuvre, utilisation effective et portée d'un programme provincial de soins dans le postpartum

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Abstract:

This paper examines implementation and uptake of the Hospital Stay and Postpartum Home Visiting Program at 5 sites in the Canadian province of Ontario using a cross-sectional survey. It also examines concomitant changes in satisfaction with services and maternal and infant health indicators by comparing the findings of this survey, administered after policy implementation, with those of a previous survey. In both surveys, data were collected via a self-administered in-hospital questionnaire and a structured telephone interview at 4 weeks postdischarge. There were statistically significant differences in implementation of the 60-hour hospital-stay option across sites, with between 11.7% and 81.2% of women having been offered an extended stay. However, there were no significant differences in acceptance rates (21.1–39.4%) among those women given this option. There were no statistically significant differences in the offer of a home visit by a public health nurse (91.5–96.6%), but there were significant differences in uptake of a visit. Between 21.1% and 39.4% of those women who were offered a home visit accepted. When compared to the previous survey findings, there were few changes in client satisfaction with services and health indicators following program implementation. This study raises questions about the utility of the postpartum program as currently implemented and highlights the need for further research.

French
Cet article analyse, sur la base d'une enquête transversale, la mise en œuvre et la portée, dans cinq localités de la province canadienne de l'Ontario, d'un programme appelé Hospital Stay and Postpartum Home Visiting Program. Comparant les résultats de la présente enquête, entreprise après la mise en œuvre du programme, à ceux d'une enquête précédente, les auteurs étudient en outre les changements concomitants touchant la satisfaction à l'égard des services et les indicateurs de santé maternelle et infantile. Les deux enquêtes ont été menées, d'une part, au moyen d'un questionnaire à remplir soi-même, distribué à l'hôpital, et, d'autre part, d'une entrevue téléphonique structurée quatre semaines suivant le congé. On rapporte des différences statistiquement significatives entre les sites relativement à la possibilité de choisir un séjour hospitalier de 60 heures, le pourcentage des femmes s'étant vu offrir un séjour prolongé variant de 11,7 % à 81,2 %. On n'a toutefois observé aucune différence significative relativement au taux d'acceptation (21,1 %-39,4 %) chez les femmes à qui on a offert ce choix. Le constat est le même en ce qui concerne l'offre d'une visite à domicile par une infirmière de santé publique (91,5 %-96,6 %), alors que l'on a observé des différences significatives relativement à la mesure dans laquelle les femmes ont réclamé une visite; entre 21,1 % et 39,4 % des femmes à qui l'on a proposé une visite à domicile ont accepté l'offre. On a constaté peu de changements entre la première enquête et la deuxième sur le plan de la satisfaction à l'égard des services et des indicateurs de santé. Ces conclusions soulèvent certaines questions quant à l'utilité du programme dans sa forme actuelle et mettent en lumière la nécessité de poursuivre les recherches à ce sujet.

Keywords: HEALTH INDICATORS; POSTPARTUM; SATISFACTION WITH; SERVICES; SURVEY; UNIVERSAL PROGRAM

Document Type: Research Article

Publication date: 2004-06-01

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