Effect of Weekend Admissions on the Treatment Process and Outcomes of Internal Medicine Patients
Journal
Medicine (United States)
Journal Volume
95
Journal Issue
6
Pages
e2643
Date Issued
2016
Author(s)
Abstract
Many studies address the effect of weekend admission on patient outcomes. This population-based study aimed to evaluate the relationship between weekend admission and the treatment process and outcomes of general internal medicine patients in Taiwan. A total of 82,340 patients (16,657 weekend and 65,683 weekday admissions) aged ?20 years and admitted to the internal medicine departments of 17 medical centers between 2007 and 2009 were identified from the Taiwan National Health Insurance Research Database. A generalized estimating equation (GEE) analysis was used to compare patients admitted on weekends and those admitted on weekdays. Patients who were admitted on weekends were more likely to undergo intubation (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.16-1.39; P<0.001) and/or mechanical ventilation (OR, 1.25; 95% CI, 1.15-1.35; P<0.001), cardio-pulmonary resuscitation (OR: 1.45; 95% CI: 1.05-2.01; P=0.026), and be transferred to the intensive care unit (ICU) (OR: 1.16; 95% CI: 1.03-1.30; P=0.015) compared with those admitted on weekdays. Weekend-Admitted patients also had higher odds of in-hospital mortality (OR: 1.19; 95% CI: 1.09-1.30; P<0.001) and hospital treatment cost (OR: 1.04; 95% CI: 1.01-1.06; P=0.008) than weekday-Admitted patients. General internal medicine patients who were admitted on weekends experienced more intensive care procedures and higher ICU admission, in-hospital mortality, and treatment cost. Intensive care utilization may serve as early indicator of poorer outcomes and a potential entry point to offer preventive intervention before proceeding to intensive treatment. Copyright ? 2016 Wolters Kluwer Health, Inc. All rights reserved.
SDGs
Other Subjects
adult; aged; Article; artificial ventilation; cellulitis; cerebrovascular accident; Charlson Comorbidity Index; chronic obstructive lung disease; congestive heart failure; cross-sectional study; female; health care cost; health care utilization; hospital admission; human; intensive care; internal medicine; intubation; ischemic heart disease; length of stay; major clinical study; male; middle aged; mortality; outcome assessment; pneumonia; population research; priority journal; resuscitation; retrospective study; Taiwan; upper gastrointestinal bleeding; urinary tract infection; weekend hospital admission; emergency treatment; hospital admission; hospital mortality; intensive care unit; internal medicine; statistics and numerical data; treatment outcome; Adult; Aged; Cross-Sectional Studies; Emergency Treatment; Female; Hospital Mortality; Humans; Intensive Care Units; Internal Medicine; Male; Middle Aged; Patient Admission; Retrospective Studies; Taiwan; Treatment Outcome
Publisher
Lippincott Williams and Wilkins
Type
journal article