title: The association between discharge before noon and length of stay in medical and surgical patients.
abstract: Discharging patients before noon is a key approach to improving bed utilization. Few data exist to describe whether patients are discharged earlier or their stay is extended to allow for an early discharge the next day.
  
  
  
  To determine if a discharge before noon (DCBN) is associated with length of stay (LOS).
  
  
  
  Retrospective analysis of data from adult medical and surgical discharges from a single academic center from July 2012 through April 2015. We used a multivariable generalized linear model to evaluate the association between DCBN and LOS.
  
  
  
  Of 38,365 hospitalizations, 6484 (16.9%) were discharged before noon, and the median LOS was 3.7 days. After adjustment, DCBN was associated with a longer LOS (adjusted odds ratio [OR]: 1.043, 95% confidence interval [CI]: 1.003-1.086). The association between longer LOS and DCBN was more pronounced in patients admitted emergently (n = 14,192, 37%) (adjusted OR: 1.14, 95% CI: 1.033-1.249).
  
  
  
  Although we cannot discern whether discharges were delayed to achieve discharge before noon, earlier discharge was associated with a longer LOS, particularly among emergent admissions. Journal of Hospital Medicine 2015;11:859-861. © 2015 Society of Hospital Medicine.
authors.affiliation: Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California.
authors.forename: Alvin
authors.initials: A
authors.lastname: Rajkomar
authors.affiliation: Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California.
authors.forename: Victoria
authors.initials: V
authors.lastname: Valencia
authors.affiliation: Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California.
authors.forename: Maria
authors.initials: M
authors.lastname: Novelero
authors.affiliation: Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California.
authors.forename: Michelle
authors.initials: M
authors.lastname: Mourad
authors.affiliation: Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California.
authors.forename: Andrew
authors.initials: A
authors.lastname: Auerbach
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors