The association between night or weekend admission and hospitalization-relevant patient outcomes.
BACKGROUND
Nights and weekends represent a potentially high-risk time for hospitalized patients. Data regarding night or weekend admission and its impact on outcomes is limited. We studied the association between night or weekend admission and outcomes.


METHODS
We reviewed 857 admissions to the general medicine services from the emergency department (ED) at our tertiary care hospital for demographic information, time and day of admission, and hospitalization-relevant outcomes (length of stay [LOS], hospital charges, intensive care unit [ICU] transfer during hospitalization, repeat ED visit within 30 days, readmission within 30 days, and poor outcome [ICU transfer, cardiac arrest, or death] within the first 24 hours of admission). Outcomes were compared between groups using univariate and multivariate modeling.


RESULTS
Complete data for analysis were available for 824 patients. A total of 58% of patients were admitted at night and 22% were admitted during the weekend. Patients admitted at night as compared to those admitted during the day had similar a LOS (4.1 vs. 4.3, P = 0.38), hospital charges (25,200 vs. 27,500, P = 0.17), ICU transfer during hospitalization (3% vs. 6%, P = 0.06), 30 day repeat ED visit (22% vs. 20%, P = 0.42), 30 day readmission (20% vs. 17%, P = 0.23), and poor outcomes within 24 hours of admission (1% vs. 2%, P = 0.15). Patients admitted during the weekend as compared to those admitted during the week had lower hospital charges and lower likelihood of an ICU transfer but were otherwise similar.


CONCLUSIONS
Night or weekend admission was not associated with worse hospitalization-relevant outcomes at our tertiary care hospital.
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. raman.khanna@ucsf.edu
Raman
R
Khanna
Kelley
K
Wachsberg
Amir
A
Marouni
Joseph
J
Feinglass
Mark V
MV
Williams
Diane B
DB
Wayne
D039602:After-Hours Care; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D019300:Medical Errors / Q000517:prevention & control; D008875:Middle Aged; D009551:Night Care; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010343:Patient Admission; D012189:Retrospective Studies; D017751:Safety Management; D013997:Time Factors; D014481:United States