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A Comparison of In-hospital Mortality Risk Conferred by High Hospital Occupancy, Differences in Nurse Staffing Levels, Weekend Admission, and Seasonal Influenza

Bibliographic Data

ID9104863
AuthorsPeter L Schilling (0000-0002-6487-0123, Robert Wood Johnson Foundation, corresponding author), Darrell A Campbell (0000-0003-0855-6145, NHS Blood and Transplant), Michael J Englesbe (0000-0001-8691-9111, NHS Blood and Transplant), Michael M Davis (0000-0002-6370-641X, University of Michigan, corresponding author), Matthew M Davis
Year2010
Volume48
Issue3
Pages224-232
Publication date2010-03-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181c162c0
PMID20168260
OpenAlexW2038437912
LanguageEN
Citations received6
References cited40

BACKGROUND: Hospital occupancy, nurse staffing levels, weekend admission, and seasonal influenza have all been shown to be associated with in-hospital mortality. Yet, no study has simultaneously compared the strength of associations of these 4 factors with in-hospital mortality. OBJECTIVE: To compare the risk of in-hospital mortality conferred by high hospital occupancy on admission, increased nurse staffing levels, weekend admission, and seasonal influenza. STUDY DESIGN: Retrospective cohort study of 166,920 patients admitted to 39 Michigan hospitals between 2003 and 2006. Participants were adults, age > or = 65 years, admitted through the emergency department with 6 common discharge diagnoses (acute myocardial infarction, congestive heart failure, stroke, pneumonia, hip fracture, gastrointestinal bleeding). We used logistic regression to compare the differences in the predicted probability of death conferred by each of the 4 factors, controlling for patient age, gender, discharge diagnosis, and comorbid conditions. RESULTS: Each of the 4 factors had a statistically significant, independent association with in-hospital mortality. Seasonal influenza conferred the greatest increase in absolute risk of in-hospital mortality (0.5 percentage points; 95% CI, 0.23-0.76), followed by weekend admission (0.32, 0.11-0.54), and high hospital occupancy on admission (0.24, 0.06-0.43). Increased nurse staffing levels decreased the absolute risk of mortality by 0.25 percentage points (0.04-0.48) for each additional full-time equivalent nurse per patient-day. CONCLUSION: Hospital occupancy, nurse staffing levels, weekend admission, and seasonal influenza all appear to be independently associated with in-hospital mortality, but to varying degrees in the current sample. These findings may guide hospital administrators as they consider factors that influence weekly and seasonal patient flow and capacity, as well as staffing

Biology · Coronavirus disease 2019 (COVID-19) · Hospital admission · Medical emergency · Occupancy · Seasonal influenza · Staffing · Emergency Medicine · Hospital Admissions and Outcomes · Internal Medicine · Medicine · Nursing · Nursing education and management · Sepsis Diagnosis and Treatment

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Unique citing works6
Citations per year0,4
Citation span2011 - 2025 (15)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 5
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