title: Weekend Discharges and Length of Stay Among Veterans Admitted for Chronic Obstructive Pulmonary Disease.
abstract: BACKGROUND
  Discharge rates are substantially lower on weekends, though the impact on hospital length of stay (LOS) is not fully understood.
  
  
  OBJECTIVE
  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.
  
  
  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.
authors.affiliation: *VA Connecticut Health Care System, West Haven †Department of Medicine, Division of Pulmonary and Critical Care, Yale University, New Haven, CT ‡Department of Veterans Affairs, VA Puget Sound Health Care System Departments of §Health Services ∥Medicine, Division of Pulmonary and Critical Care, University of Washington, Seattle, WA ¶Department of Medicine, Baystate Medical Center, Springfield, MA.
authors.forename: Seppo T
authors.initials: ST
authors.lastname: Rinne
authors.forename: Edwin S
authors.initials: ES
authors.lastname: Wong
authors.forename: Paul L
authors.initials: PL
authors.lastname: Hebert
authors.forename: David H
authors.initials: DH
authors.lastname: Au
authors.forename: Peter K
authors.initials: PK
authors.lastname: Lindenauer
authors.forename: Emily L
authors.initials: EL
authors.lastname: Neely
authors.forename: Christine A
authors.initials: CA
authors.lastname: Sulc
authors.forename: Chuan-Fen
authors.initials: CF
authors.lastname: Liu
mesh_terms: D000368:Aged; D005260:Female; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors; D014481:United States; D014728:Veterans