The association between night or weekend admission and hospitalization-relevant patient outcomes

J Hosp Med. 2011 Jan;6(1):10-4. doi: 10.1002/jhm.833. Epub 2010 Nov 24.

Abstract

Introduction: 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.

Conclusion: Night or weekend admission was not associated with worse hospitalization-relevant outcomes at our tertiary care hospital.

MeSH terms

  • After-Hours Care*
  • Continuity of Patient Care
  • Female
  • Humans
  • Male
  • Medical Audit
  • Medical Errors / prevention & control
  • Middle Aged
  • Night Care*
  • Outcome Assessment, Health Care / methods*
  • Patient Admission*
  • Retrospective Studies
  • Safety Management
  • Time Factors
  • United States