Abstract:
BACKGROUND:Although hospital admissions during weekends have been associated with worse quality of care and worse outcomes in some but not all medical conditions, the impact of weekend versus weekday admission and discharge for heart failure (HF) has not been well studied. This study investigates the association of (1) weekend compared to weekday HF admissions and discharges with quality of care and (2) weekend versus weekday HF admissions with length of stay (LOS) and mortality in the hospital. METHODS:Data were analyzed for 81,810 HF admissions at 241 sites participating in Get With the Guidelines (GWTG)-HF from January 2005 to September 2008. The cohort was stratified by weekend versus weekday admission and discharge. Generalized estimating equations adjusted for patient and hospital characteristics and clustering. RESULTS:Mean age was 72 +/- 14 years; left ventricular ejection fraction (LVEF) was 39+/-17%. Inhospital mortality was 3.0% and median LOS 4 days. Weekend admission was associated with decreased odds of LVEF documentation. Weekend discharge was associated with decreased odds of LVEF documentation and completed discharge instructions. Weekend HF admission compared to weekday admission was associated with slightly higher risk-adjusted odds of longer inhospital LOS (1.03 [1.01-1.05] and increased inhospital mortality (1.13 [1.02-1.27]). CONCLUSIONS:Among GWTG-HF hospitals, weekend admission and discharge for HF were associated with similar quality of care in many but not all measures. Risk-adjusted LOS was slightly longer and mortality moderately higher for weekend HF admissions.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Horwich TB,Hernandez AF,Liang L,Albert NM,Labresh KA,Yancy CW,Fonarow GC,Get With Guidelines Steering Committee and Hospitals.doi
10.1016/j.ahj.2009.06.025subject
Has Abstractpub_date
2009-09-01 00:00:00pages
451-8issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(09)00480-3journal_volume
158pub_type
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章
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