The impact of the day of the week and month of admission on the length of hospital stay in stroke patients.

BACKGROUND

Length of hospital stay (LOS) in many diseases is determined by patient-related sociodemographic and clinical factors but also by the management of treatment and care. We examined the influence of the day of the week (DW) and month of admission on LOS in stroke patients.

METHODS

We used data from a large regional stroke registry in the northwest of Germany for the years 2000 and 2001. The registry is based on a standardised data assessment in participating hospitals, including patient-related sociodemographic and clinical items, diagnostic and treatment procedures, stroke classification, as well as admission and discharge dates. Data management and analysis were done centrally.

RESULTS

A total of 11,942 patients from 42 hospital departments were included. Median LOS was 13 days for ischemic stroke and 8 days for TIA. Patients with ischaemic stroke admitted on Tuesdays or Wednesdays had the longest LOS. We observed a significantly shorter LOS in patients discharged towards the weekend, both for ischaemic stroke and TIA, independent of age, gender and symptom severity. Discharges were predominantly done on Fridays (25%), transferrals to rehabilitation centres most often on Thursdays (28%) in neurologic departments but on Tuesdays in departments of internal medicine. LOS according to the month of admission revealed a biphasic curve for both ischaemic stroke and TIA, with shortest LOS in July and December.

CONCLUSIONS

Discharge patterns on weekends contribute to differences in LOS for the various DWs of admission. Changes in discharge organisation and improved co-operation with rehabilitation centres may shorten LOS. Differences in LOS between the months show considerable seasonal variability.