Bull Hosp Jt Dis (2013). 2024 Sep;82(3):224-228.
Health care institutions are searching for system-wide approaches to reduce costs while maintaining quality and improving patient outcomes. Hospital length of stay (LOS) and readmission rate (RR) are variables that significantly impact health care costs. This investigation aimed to determine if there was a difference in the LOS and the RR for pediatric orthopedic patients admitted overnight or during the weekend.
We analyzed 243 admissions for pediatric orthopedic surgery cases between September 2016 and August 2018 at a single-specialty orthopedic hospital. We categorized admissions into elective surgeries, infectious etiologies, and trauma and accidents. We compared the time and day of the week of admission to the average LOS and RR.
The mean LOS of the entire cohort was 2.93 days. The mean LOS for trauma admissions was 1.90 days, the mean LOS for elective surgeries was 3.34 days, and the mean LOS for infections was 4.11 (p = 0.00009). The mean LOS for patients admitted on a weekday was 3.00 days; the mean LOS for patients admitted on the weekend was 2.33 days (p = 0.28). The mean LOS for patients admitted between 6:00 AM and 6:00 PM was 3.12 days, and the mean LOS for patients admitted between 6:00 PM and 6:00 AM was 2.66 days (p = 0.22). The mean LOS for patients admitted during regular operating hours was 3.12 days, and the mean LOS for patients admitted during off-hours was 2.67 days (p = 0.22). The mean RR for trauma admissions was 0.0%, the mean RR for elective surgeries was 4.5%, and the mean for infections was 3.7% (p = 0.1073). The mean RR for patients admitted on a weekday was 3.2%, and the mean RR for patients admitted on the weekend was 0.0% (p = 0.37). The mean RR for patients admitted between 6:00 AM and 6:00 PM was 4.2%, and the mean RR for patients admitted between 6:00 PM and 6:00 AM was 1.0% (p = 0.15). The mean RR for patients admitted during regular operating hours was 4.2%, and the mean RR for patients admitted during off-hours was 1.0% (p = 0.14).
This study showed no relationship between the day or time of admission and the LOS or RR for pediatric orthopedic admissions. Our results support the institutional goal of maintaining operations overnight and on weekends while not compromising patient outcomes.
医疗机构正在寻找全系统的方法来降低成本，同时保持质量并改善患者的治疗效果。住院时间（LOS）和再入院率（RR）是显著影响医疗成本的变量。本研究旨在确定在夜间或周末入院的儿科骨科患者的 LOS 和 RR 是否存在差异。
我们分析了 2016 年 9 月至 2018 年 8 月期间在一家专业骨科医院接受的 243 例儿科骨科手术病例。我们将入院分为择期手术、感染性病因和创伤和事故。我们比较了入院时间和入院日与平均 LOS 和 RR 的关系。
整个队列的平均 LOS 为 2.93 天。创伤性入院的平均 LOS 为 1.90 天，择期手术的平均 LOS 为 3.34 天，感染的平均 LOS 为 4.11（p=0.00009）。在工作日入院的患者平均 LOS 为 3.00 天，在周末入院的患者平均 LOS 为 2.33 天（p=0.28）。上午 6:00 至下午 6:00 入院的患者平均 LOS 为 3.12 天，下午 6:00 至上午 6:00 入院的患者平均 LOS 为 2.66 天（p=0.22）。在常规手术时间入院的患者平均 LOS 为 3.12 天，在非手术时间入院的患者平均 LOS 为 2.67 天（p=0.22）。创伤性入院的平均 RR 为 0.0%，择期手术的平均 RR 为 4.5%，感染的平均 RR 为 3.7%（p=0.1073）。在工作日入院的患者平均 RR 为 3.2%，在周末入院的患者平均 RR 为 0.0%（p=0.37）。上午 6:00 至下午 6:00 入院的患者平均 RR 为 4.2%，下午 6:00 至上午 6:00 入院的患者平均 RR 为 1.0%（p=0.15）。在常规手术时间入院的患者平均 RR 为 4.2%，在非手术时间入院的患者平均 RR 为 1.0%（p=0.14）。
本研究表明，儿科骨科患者入院的日期或时间与 LOS 或 RR 之间没有关系。我们的结果支持医疗机构维持夜间和周末运营的目标，同时不影响患者的治疗效果。
