Division of Public Health and Epidemiology, University of Nottingham.
Royal Derby Hospital.
Clin Med (Lond). 2017 Dec;17(6):504-507. doi: 10.7861/clinmedicine.17-6-504.
We hypothesised that delays in providing non-urgent medication step-downs at weekends to medical management may be associated with increased length of stay.In a novel use of electronic prescribing data, we analysed emergency admissions from a busy acute medical hospital over 52 weeks from November 2014 to October 2015. The main outcomes of interest were switching from intravenous antibiotics to oral antibiotics and stopping nebulised bronchodilators. The rate of switching from intravenous to oral antibiotics was lower on Saturdays and Sundays compared with weekdays, and the rate of stopping nebulised bronchodilators was similarly lower at weekends (p<0.001). Median length of stay was shorter in those whose antibiotic treatment was stepped down at weekends compared with weekdays (4 days versus 5 days, p<0.001). Reduced medication step-downs at weekends may represent a bottleneck in patient flow. Electronic prescribing data are a valuable resource for future health services research.
我们假设，周末在提供非紧急药物逐步减少剂量方面的延迟可能与住院时间延长有关。在对电子处方数据的新颖使用中，我们分析了 2014 年 11 月至 2015 年 10 月 52 周内一家繁忙的急性内科医院的急诊入院情况。主要关注的结果是从静脉用抗生素转换为口服抗生素和停止雾化支气管扩张剂。与平日相比，周六和周日静脉用抗生素转为口服抗生素的速度较低，周末停止雾化支气管扩张剂的速度也较低（p<0.001）。与平日相比，周末接受抗生素治疗逐步减少的患者的住院时间更短（4 天与 5 天，p<0.001）。周末减少药物剂量可能代表患者流动的瓶颈。电子处方数据是未来卫生服务研究的宝贵资源。
