周末出院与再次入院有关吗？

Is weekend discharge associated with hospital readmission?

作者信息

Cloyd Jordan M, Chen Joy C, Ma Yifei, Rhoads Kim F

机构信息

Department of Surgery, Stanford University, Stanford, California.

出版信息

J Hosp Med. 2015 Nov;10(11):731-7. doi: 10.1002/jhm.2406. Epub 2015 Jun 30.

DOI:10.1002/jhm.2406

PMID:26130366

Abstract

BACKGROUND

Although recent evidence suggests worse outcomes for patients admitted to the hospital on a weekend, the impact of weekend discharge is less understood.

METHODS

Utilizing the 2012 California Office of Statewide Health Planning and Development database, the impact of weekend discharge on 30-day hospital readmission rates for patients admitted with acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia (PNA) was investigated.

RESULTS

Out of 266,519 patients, 60,097 (22.5%) were discharged on a weekend. Unadjusted 30-day hospital readmission rates were similar between weekend and weekday discharges (AMI: 21.9% vs 21.9%; CHF: 15.4% vs 16.0%; PNA: 12.1% vs 12.4%). Patients discharged on a weekday had a longer length of stay and were more often discharged to a skilled nursing facility. However, in multivariable logistic regression models, weekend discharge was not associated with readmission (AMI: odds ratio [OR] 1.02 [95% CI: 0.98-1.06]; CHF: OR 0.99 [95% CI: 0.94-1.03]; PNA: OR 1.02 (95% CI: 0.98-1.07)).

CONCLUSIONS

Among patients in California with AMI, CHF, and PNA, discharge on a weekend was not associated with an increased hospital readmission rate.

摘要

背景

尽管近期证据表明周末入院的患者预后较差，但周末出院的影响却鲜为人知。

方法

利用2012年加利福尼亚州全州卫生规划与发展办公室数据库，研究了周末出院对急性心肌梗死（AMI）、充血性心力衰竭（CHF）或肺炎（PNA）患者30天再入院率的影响。

结果

在266,519名患者中，60,097名（22.5%）在周末出院。周末和工作日出院的未调整30天再入院率相似（AMI：21.9%对21.9%；CHF：15.4%对16.0%；PNA：12.1%对12.4%）。工作日出院的患者住院时间更长，更常被转至专业护理机构。然而，在多变量逻辑回归模型中，周末出院与再入院无关（AMI：比值比[OR]1.02[95%CI：0.98 - 1.06]；CHF：OR 0.99[95%CI：0.94 - 1.03]；PNA：OR 1.02[95%CI：0.98 - 1.07]）。