Hospital care for patients experiencing weekend vs weekday stroke: a comparison of quality and aggressiveness of care.
BACKGROUND
We examined the quality and aggressiveness of care for the treatment of acute ischemic stroke (AIS) on weekends vs weekdays. Acute ischemic stroke is a leading cause of death and disability in the United States, and aggressive treatment must be provided within 3 hours for optimal patient outcomes. Because of this short treatment window for the administration of tissue plasminogen activator, patients need around-the-clock access to high-quality and aggressive care.


OBJECTIVE
To determine whether there is a difference in the quality or aggressiveness of care for patients experiencing AIS on weekends vs weekdays.


METHODS
Retrospective study.


METHODS
Academic research. Patients We conducted a retrospective study of patients with AIS in Virginia. Two logistic regression analyses assessed the relationship between weekend admission and quality and aggressiveness of care, while controlling for appropriate patient-level and hospital-level control variables. A propensity score stratification approach controlled for selection bias.


METHODS
Treatment with tissue plasminogen activator and in-hospital mortality.


RESULTS
Patients with AIS admitted on weekends are more likely to receive tissue plasminogen activator than those admitted on weekdays (P < .05). No statistically significant difference was noted in patient mortality based on day of admission (P >or= .05). We detected no difference in the likelihood to seek hospital care on weekends between patients with AIS vs patients with hemorrhagic stroke.


CONCLUSIONS
Patients experiencing AIS are more likely to receive tissue plasminogen activator on weekends than on weekdays. Patients experiencing AIS who are admitted on weekends are no more likely to die than those who are admitted on weekdays. Further research is necessary to understand differences in weekend vs weekday care.
Kazley
Abby S
AS
Department of Health Professions, Medical University of South Carolina, 151 Rutledge Ave, Charleston, SC 29425, USA. swansoaj@musc.edu
Hillman
Diane Gartner
DG
Johnston
Karen C
KC
Simpson
Kit N
KN
D000368:Aged; D002423:Cause of Death; D004632:Emergency Medical Services / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000401:mortality / Q000628:therapy*; D007902:Length of Stay; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D010561:Personnel Staffing and Scheduling / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D057216:Propensity Score; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014481:United States / Q000453:epidemiology; D014768:Virginia / Q000453:epidemiology
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator