Persaud Alana, Patel Pavan, Motlaghzadeh Yasaman, Ahlawat Sushil
Division of Medicine Rutgers New Jersey Medical School Newark New Jersey USA.
Division of Gastroenterology and Hepatology Rutgers New Jersey Medical School Newark New Jersey USA.
JGH Open. 2019 Jun 10;4(1):44-48. doi: 10.1002/jgh3.12205. eCollection 2020 Feb.
The weekend effect describes worsened outcomes due to perceived inefficiency occurring over the weekend. This effect has not been studied in inflammatory bowel disease (IBD) despite increasing prevalence in the community. Therefore, our aim is to assess differences in the outcomes of weekend weekday management of IBD exacerbations.
The National Inpatient Sample database comprises approximately 20% of admissions to nonfederal hospitals in the United States. Complications requiring hospitalization ("flares") were the criteria upon which patient selection was based. A total of 193, 848 flares were identified from 2008 to 2014 using the International Classification of Diseases 9th edition codes. Differences in time to first procedure, length of stay (LOS), and cost were evaluated for patients with flares between weekend and weekday admissions.
The time to first procedure was 3.33 days on weekends 3.19 days on weekdays ( < 0.001). The mean LOS was shorter when admissions occurred on weekends weekdays (8.01 days 8.22 days, < 0.001). Finally, the cost of hospitalization was higher for weekday admissions weekend admissions ($18 072 $17 495, < 0.001).
Our results showed a similar LOS and cost associated with the management of exacerbations on the weekend compared to weekdays. While many high-risk conditions exhibit increased mortality and prolonged hospital course over the weekend, this phenomenon does not appear to affect IBD. These findings indicate efficient patient care on the weekend and can be utilized for logistical purposes such as resource allocation and procedure scheduling in the endoscopy suite.
周末效应描述了因周末被认为效率低下而导致的不良后果。尽管社区中炎症性肠病（IBD）的患病率不断上升，但尚未对这种效应进行研究。因此，我们的目的是评估IBD急性发作在周末和工作日管理结果的差异。
国家住院样本数据库包含美国非联邦医院约20%的住院病例。需要住院治疗的并发症（“发作”）是选择患者的标准。使用国际疾病分类第9版编码，从2008年至2014年共识别出193848次发作。对周末和工作日入院的发作患者的首次手术时间、住院时间（LOS）和费用差异进行了评估。
周末的首次手术时间为3.33天，工作日为3.19天（P<0.001）。周末入院时的平均住院时间比工作日短（8.01天对8.22天，P<0.001）。最后，工作日入院的住院费用高于周末入院（18072美元对17495美元，P<0.001）。
我们的结果显示，与工作日相比，周末急性发作管理的住院时间和费用相似。虽然许多高危疾病在周末的死亡率增加且住院时间延长，但这种现象似乎不会影响IBD。这些发现表明周末患者护理效率高，可用于后勤目的，如内镜室的资源分配和手术安排。
