Weekend Discharges and Length of Stay Among Veterans Admitted for Chronic Obstructive Pulmonary Disease

Datos Bibliográficos

ID9102842
AutoresSeppo T Rinne (0000-0002-8662-1224, VA Connecticut Healthcare System, autor de correspondencia), Edwin S Wong (0000-0002-6079-686X, VA Puget Sound Health Care System), Paul L Hebert (0000-0002-5886-7964, VA Puget Sound Health Care System), David H Au (0000-0001-8207-4975, University of Washington), Peter K Lindenauer (0000-0002-8414-0507, Baystate Medical Center), Emily L Neely (VA Puget Sound Health Care System), Christine A Sulc (VA Puget Sound Health Care System), Chuan-Fen Liu, Chuan‐Fen Liu (0000-0002-6915-8194, VA Puget Sound Health Care System)
Año2015
Volumen53
Número9
Páginas753-757
Fecha de publicación2015-09-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000395
PMID26147865
OpenAlexW840960359
IdiomaEN
Citas recibidas2
Referencias citadas21

BACKGROUND: Discharge rates are substantially lower on weekends, though the impact on hospital length of stay (LOS) is not fully understood. OBJECTIVES: The primary objective was to examine the association of weekend discharges with hospital LOS. We also examined the association of weekend discharges with readmission, mortality, and postdischarge follow-up. RESEARCH DESIGN AND METHODS: A cohort study of 25,301 patients who were admitted to Veterans Affairs hospitals for chronic obstructive pulmonary disease during October 01, 2008-September 30, 2010, including 3845 patients discharged on the weekend (Saturday or Sunday) and 21,456 discharged on weekdays (Monday through Friday). RESULTS: There were significantly fewer discharges on the weekend (1922 per weekend day vs. 4279 per weekday, P<0.01). Inpatient status during the weekend at any point in hospitalization was associated with an increased LOS of 0.59 day [95% confidence interval (CI), 0.54-0.63 d]. Discharge on the weekend was not associated with increased odds of 30-day hospital readmission [odds ratio (OR)=1.00; 95% CI, 0.90-1.10] or lack of primary care follow-up visit within 14 days of discharge (OR=0.94; 95% CI, 0.85-1.03). However, weekend discharges were significantly associated with lower odds of mortality within 30 days after discharge (OR=0.80; 95% CI, 0.65-0.99). CONCLUSIONS: The presence of fewer weekend discharges was associated with significantly longer hospital lengths of stay. Weekend discharges were not associated with higher readmission rates and had lower rates of mortality compared with weekdays discharges. Identifying methods to increase weekend discharges may create an opportunity to improve hospital efficiency

Confidence interval · Hospital admission · Logistic regression · Odds · Odds ratio · Pulmonary disease · Veterans Affairs · Weekend effect · Chronic Obstructive Pulmonary Disease (COPD) Research · Demography · Emergency and Acute Care Studies · Emergency Medicine · Hospital Admissions and Outcomes · Internal Medicine · Medicine