title: Effect of Weekend Admissions on the Treatment Process and Outcomes of Internal Medicine Patients: A Nationwide Cross-Sectional Study.
abstract: Many studies address the effect of weekend admission on patient outcomes. This population-based study aimed to evaluate the relationship between weekend admission and the treatment process and outcomes of general internal medicine patients in Taiwan.A total of 82,340 patients (16,657 weekend and 65,683 weekday admissions) aged ≥20 years and admitted to the internal medicine departments of 17 medical centers between 2007 and 2009 were identified from the Taiwan National Health Insurance Research Database. A generalized estimating equation (GEE) analysis was used to compare patients admitted on weekends and those admitted on weekdays.Patients who were admitted on weekends were more likely to undergo intubation (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.16-1.39; P < 0.001) and/or mechanical ventilation (OR, 1.25; 95% CI, 1.15-1.35; P < 0.001), cardio-pulmonary resuscitation (OR: 1.45; 95% CI: 1.05-2.01; P = 0.026), and be transferred to the intensive care unit (ICU) (OR: 1.16; 95% CI: 1.03-1.30; P = 0.015) compared with those admitted on weekdays. Weekend-admitted patients also had higher odds of in-hospital mortality (OR: 1.19; 95% CI: 1.09-1.30; P < 0.001) and hospital treatment cost (OR: 1.04; 95% CI: 1.01-1.06; P = 0.008) than weekday-admitted patients.General internal medicine patients who were admitted on weekends experienced more intensive care procedures and higher ICU admission, in-hospital mortality, and treatment cost. Intensive care utilization may serve as early indicator of poorer outcomes and a potential entry point to offer preventive intervention before proceeding to intensive treatment.
authors.affiliation: From the Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei (C-CH); Master Degree Program in Aging and Long-Term Care, Kaohsiung Medical University, Kaohsiung (Y-TH); Department of Internal Medicine (N-CH, C-JY); Division of Hospital Medicine (N-CH, J-SC); Department of Traumatology; and Department of Surgery, National Taiwan University Hospital (J-SC), Taipei, Taiwan.
authors.forename: Chun-Che
authors.initials: CC
authors.lastname: Huang
authors.forename: Yu-Tung
authors.initials: YT
authors.lastname: Huang
authors.forename: Nin-Chieh
authors.initials: NC
authors.lastname: Hsu
authors.forename: Jin-Shing
authors.initials: JS
authors.lastname: Chen
authors.forename: Chong-Jen
authors.initials: CJ
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004638:Emergency Treatment; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013624:Taiwan; D016896:Treatment Outcome