Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6 JCP, Iowa City, IA 52242, United States of America.
Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miami, FL, United States of America.
J Clin Anesth. 2018 Nov;50:27-32. doi: 10.1016/j.jclinane.2018.06.037. Epub 2018 Jun 27.
We tested the hypothesis that over many years - a decade - hospitals' proportions of surgical cases that were performed on weekends and holidays remained stable.
Retrospective cohort study.
Iowa Hospital Association data were from January 1, 2007, through June 30, 2017. The N = 42 hospitals included were those with at least 10 cases performed during holidays or weekends for each of the periods.
The number of surgical cases performed at each hospital during each of the 21 half-year periods was considered the count of unique combinations of hospital, patient, and date with at least one major therapeutic procedure.
Absolute predictive errors in cases per weekend or holiday day were calculated using a proportional model and using a quadratic model for each hospital and half-year period. Pooling among hospitals, the sample mean absolute predictive errors were greater for the proportional model than for the quadratic model (P < 0.0001). However, the mean difference was just 0.0027 cases per weekend or holiday day (SE 0.0001), significantly less than even 1 case per day (P < 0.0001). The sample means of the pairwise differences in predictive errors were smaller than 1 case per day for all 42 hospitals, significantly so for 41 of the 42 hospitals (P ≤ 0.005). These conditions applied to all other hospitals in the state, because each performed few cases on weekends and holidays.
For the anesthesia group caring for patients at a hospital over several years, weekend and holiday anesthesia caseload should be expected to increase approximately proportionately to changes during regular workdays. Average weekend workload can be benchmarked using hospitals' percentages of operating room cases performed on weekends and holidays.
我们检验了这样一个假设，即在多年时间里——十年——医院周末和节假日施行的手术比例保持稳定。
回顾性队列研究。
爱荷华州医院协会的数据来自 2007 年 1 月 1 日至 2017 年 6 月 30 日。纳入的 42 家医院至少在每个时期的节假日施行 10 例以上手术。
每家医院在每个 21 个半年期施行的手术例数被视为医院、患者和日期的独特组合的计数，其中至少有一项主要治疗程序。
使用比例模型和二次模型为每家医院和每个半年期计算周末或节假日施行的手术例数的绝对预测误差。在医院之间进行汇总，比例模型的样本平均绝对预测误差大于二次模型（P<0.0001）。然而，平均差异仅为 0.0027 例/周末或节假日（SE 0.0001），显著小于 1 例/天（P<0.0001）。所有 42 家医院的预测误差差异的样本均值小于 1 例/天，其中 41 家显著如此（P≤0.005）。这些条件适用于该州的所有其他医院，因为每家医院在周末和节假日施行的手术例数都很少。
对于在一家医院照顾患者多年的麻醉团队来说，周末和节假日施行的麻醉手术量预计将与工作日期间的变化成比例增加。可以使用医院在周末和节假日施行的手术室手术比例来对平均周末工作量进行基准测试。
