Schmidt Wolf-Peter, Taeger Dirk, Buecker-Nott Hans-Joachim, Berger Klaus
Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany.
Cerebrovasc Dis. 2003;16(3):247-52. doi: 10.1159/000071123.
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.
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.
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.
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.
许多疾病的住院时间（LOS）由患者相关的社会人口统计学和临床因素决定，但也受治疗和护理管理的影响。我们研究了一周中的日期（DW）和入院月份对中风患者住院时间的影响。
我们使用了2000年和2001年德国西北部一个大型地区中风登记处的数据。该登记处基于参与医院的标准化数据评估，包括患者相关的社会人口统计学和临床项目、诊断和治疗程序、中风分类以及入院和出院日期。数据管理和分析在中心进行。
共纳入了来自42个医院科室的11942名患者。缺血性中风的中位住院时间为13天，短暂性脑缺血发作（TIA）为8天。在周二或周三入院的缺血性中风患者住院时间最长。我们观察到，无论是缺血性中风还是TIA患者，在周末出院时住院时间明显较短，且与年龄、性别和症状严重程度无关。出院主要在周五进行（25%），转至康复中心最常在周四（28%）在神经科进行，但在内科则在周二。根据入院月份的住院时间显示，缺血性中风和TIA均呈双相曲线，7月和12月住院时间最短。
周末的出院模式导致不同入院日期的住院时间存在差异。改变出院安排并改善与康复中心的合作可能会缩短住院时间。各月份之间住院时间的差异显示出相当大的季节性变化。
