C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan.
Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.
Hosp Pediatr. 2022 Jan 1;12(1):79-85. doi: 10.1542/hpeds.2021-006039.
To evaluate whether admission on weekends affects the length of stay (LOS) for patients hospitalized with somatic symptom and related disorders (SSRDs).
Data from 2012-2018 was obtained for all patients aged 4 to 21 years (N = 5459) with a primary discharge diagnosis of SSRDs from 52 tertiary care pediatric hospitals in the United States. We obtained patient demographics, admission date and/or time, LOS, procedure count, and comorbid conditions. We defined a weekend as 3 pm Friday to 3 pm Sunday. The Wilcoxon rank test was used for unadjusted analysis. Multiple logistic regression was used to estimate the odds of having LOS >1 day, >2 days, >3 days, and >4 days in weekend versus weekday groups.
Weekend admission significantly correlated with increased LOS (P < .001). Compared with weekdays, a weekend admission was associated with increased odds of having LOS >1, >2, and >3 days. This remained statistically significant while adjusting for the number of chronic conditions, procedures, and individuals with Black or Hispanic ethnicity compared with White ethnicity. LOS was not associated with sex or age of the patients.
Patients with SSRDs admitted on the weekend have an increased LOS compared with those admitted on a weekday. This may be due to a decrease in multidisciplinary care available during weekends. In future studies, researchers should aim to better understand the specific factors that contribute to this disparity and test interventions that may close the gap in care, including expanding to 7-day services, increasing mental health resources, and working to decrease the need for inpatient admissions.
评估周末入院是否会影响躯体症状及相关障碍(SSRDs)患者的住院时间(LOS)。
从美国 52 家三级儿童保健医院 2012 年至 2018 年所有年龄在 4 至 21 岁(N=5459)、主要出院诊断为 SSRDs 的患者中获得数据。我们获得了患者人口统计学资料、入院日期和/或时间、LOS、手术次数和合并症。我们将周末定义为周五下午 3 点至周日下午 3 点。使用 Wilcoxon 秩检验进行未调整分析。使用多因素逻辑回归估计周末与工作日相比 LOS >1 天、>2 天、>3 天和>4 天的可能性。
周末入院与 LOS 增加显著相关(P<.001)。与工作日相比,周末入院与 LOS >1、>2 和>3 天的可能性增加相关。在调整慢性疾病数量、手术次数以及与白种人相比具有黑人和西班牙裔的个体后,这仍然具有统计学意义。LOS 与患者的性别或年龄无关。
与工作日入院的患者相比,SSRDS 患者周末入院的 LOS 增加。这可能是由于周末可提供的多学科护理减少所致。在未来的研究中,研究人员应旨在更好地了解导致这种差异的具体因素,并测试可能缩小护理差距的干预措施,包括扩大到 7 天服务、增加心理健康资源以及努力减少住院需求。