title: Incidence of "never events" among weekend admissions versus weekday admissions to US hospitals: national analysis.
abstract: OBJECTIVE
  To evaluate the association between weekend admission to hospital and 11 hospital acquired conditions recently considered by the Centers for Medicare and Medicaid as "never events" for which resulting healthcare costs are not reimbursed.
  
  
  METHODS
  National analysis.
  
  
  METHODS
  US Nationwide Inpatient Sample discharge database.
  
  
  METHODS
  351 million patients discharged from US hospitals, 2002-10.
  
  
  METHODS
  Univariate rates and multivariable likelihood of hospital acquired conditions among patients admitted on weekdays versus weekends, as well as the impacts of these events on prolonged length of stay and total inpatient charges.
  
  
  RESULTS
  From 2002 to 2010, 351,170,803 patients were admitted to hospital, with 19% admitted on a weekend. Hospital acquired conditions occurred at an overall frequency of 4.1% (5.7% among weekend admissions versus 3.7% among weekday admissions). Adjusting for patient and hospital cofactors the probability of having one or more hospital acquired conditions was more than 20% higher in weekend admissions compared with weekday admissions (odds ratio 1.25, 95% confidence interval 1.24 to 1.26, P<0.01). Hospital acquired conditions have a negative impact on both hospital charges and length of stay. At least one hospital acquired condition was associated with an 83% (1.83, 1.77 to 1.90, P<0.01) likelihood of increased charges and 38% likelihood of prolonged length of stay (1.38, 1.36 to 1.41, P<0.01).
  
  
  CONCLUSIONS
  Weekend admission to hospital is associated with an increased likelihood of hospital acquired condition, cost, and length of stay. Future protocols and staffing regulations must be tailored to the requirements of this high risk subgroup.
authors: Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
authors: Frank J
authors: FJ
authors: Attenello
authors: Keck School of Medicine, University of Southern California, USA wentimot@usc.edu.
authors: Timothy
authors: T
authors: Wen
authors: Department of Neurology, Keck School of Medicine, University of Southern California, USA Department of Radiology, Keck School of Medicine, University of Southern California, USA.
authors: Steven Y
authors: SY
authors: Cen
authors: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, USA.
authors: Alvin
authors: A
authors: Ng
authors: Department of Neurology, Keck School of Medicine, University of Southern California, USA.
authors: May
authors: M
authors: Kim-Tenser
authors: Department of Neurology, Keck School of Medicine, University of Southern California, USA.
authors: Nerses
authors: N
authors: Sanossian
authors: Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
authors: Arun P
authors: AP
authors: Amar
authors: Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
authors: William J
authors: WJ
authors: Mack
mesh_terms: D000293:Adolescent; D000328:Adult; D039602:After-Hours Care; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult