Odense Patient Exploratory Network (Open), Odense University Hospital, J.B. Winsløws Vej 9 A, 3. Sal, Odense 5000, Denmark.
Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3. Sal, Odense 5000, Denmark.
Int J Qual Health Care. 2021 Feb 5;33(1). doi: 10.1093/intqhc/mzab008.
The Danish health-care system has witnessed noticeable changes in the acute hospital care organization. The reconfiguration includes closing hospitals, centralizing acute care functions and investing in new buildings and equipment.
To examine the impact on the length of stay (LOS) and the proportion of overnight stays for hospitalized acute care patients.
This nationwide interrupted time series examined trend changes in LOS and overnight stay. Admissions were stratified based on admission time (weekdays/weekends and time of day), age and the level of co-morbidity.
In 2007-2016, the global average LOS declined 2.9% per year (adjusted time ratio [CI (confidence interval) 95%] 0.971 [0.970-0.971]). The reconfiguration was overall not associated with change in trend of LOS (time ratio [CI 95%] 1.001 [1.000-1.002]). When admissions were stratified for either weekdays or weekends, the reconfiguration was associated with reduction of the underlying downward trend for weekdays (time ratio [CI 95%] 1.004 [1.003-1.005]) and increased downward trend for weekend admissions (time ratio [CI 95%] 0.996 [0.094-0.098]). Admissions at night were associated with a 0.7% trend change in LOS (time ratio [CI 95%] 0.993 [0.991-0.996]). The reconfiguration was not associated with trend changes for overnight stays.
The nationwide reconfiguration of acute hospital care was overall not associated with change in trend for the registered LOS and no change in trend for overnight stays. However, the results varied according to hospitalization time, where admissions during weekends and nights after the reconfiguration were associated with shortened LOS.
丹麦的医疗保健系统见证了急性医院护理组织的显著变化。这种重新配置包括关闭医院、集中急性护理功能以及投资于新建筑和设备。
研究对住院急性护理患者的住院时间（LOS）和过夜停留比例的影响。
本全国性的中断时间序列研究检查了 LOS 和过夜停留的趋势变化。根据入院时间（平日/周末和一天中的时间）、年龄和合并症水平对入院进行分层。
2007-2016 年，全球平均 LOS 每年下降 2.9%（调整后的时间比[置信区间 95%]0.971[0.970-0.971]）。总体而言，重新配置与 LOS 趋势变化无关（时间比[95%CI]1.001[1.000-1.002]）。当按平日或周末对入院进行分层时，重新配置与工作日基础下降趋势的减少相关（时间比[95%CI]1.004[1.003-1.005]）和周末入院的下降趋势增加（时间比[95%CI]0.996[0.094-0.098]）。夜间入院与 LOS 趋势变化 0.7%相关（时间比[95%CI]0.993[0.991-0.996]）。重新配置与过夜停留的趋势变化无关。
急性医院护理的全国性重新配置总体上与登记的 LOS 趋势变化无关，也没有过夜停留的趋势变化。然而，结果根据住院时间而有所不同，重新配置后周末和夜间入院与 LOS 缩短有关。
