Premium
Similar outcomes for general medicine patients discharged on any day of the week
Author(s) -
Au John,
Horwood Chris,
Hakendorf Paul,
Thompson Campbell
Publication year - 2019
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.14083
Subject(s) - medicine , weekend effect , adverse effect , emergency medicine , comorbidity , names of the days of the week , hospital readmission , hospital admission , patient discharge , medline , philosophy , linguistics , political science , law
Background Hospital congestion is worsened by fewer patients being discharged on the weekend than on weekdays. Weekend admissions fare worse in hospital than weekday admissions. Understanding the fate of patients discharged on the weekend, or any particular weekday, may help optimise hospital discharge processes. Aim To determine the effects of weekend and specific weekday discharges on adverse outcomes (mortality and readmission to hospital). Methods Electronic records were used to identify unplanned admissions to two large public hospitals across a 5‐year period. Day of week of discharge, the inpatient length of stay, unplanned readmissions and mortality rate were determined. Results There was a significant reduction in discharges on the weekend (49%), particularly for patients who were older or with significant comorbidity ( P < 0.001). Adjusting for these differences, there was no difference in readmission and mortality between weekday and weekend discharges within two (OR 0.97; 95% CI 0.83–1.14; P < 0.76) or seven (OR 0.91; 95% CI 0.82–1.01; P < 0.07) days of discharge. By 30 days, there were significantly fewer adverse outcomes for those discharged on the weekend (OR 0.89; 95% CI 0.83–0.96; P < 0.001). There was no difference in adverse outcome rates for patients discharged on Mondays, Wednesdays or Fridays. Conclusion Fewer patients are discharged on the weekend and these are typically younger, less complex patients. Patients discharged on the weekend fare similarly or better than those discharged on a weekday. Therefore, a push to discharge more patients on the weekend could improve hospital efficiency without compromising patient care.