Evaluation of weekend admission on the prevalence of hospital acquired conditions in patients receiving thoracolumbar fusions

Attenello, Frank J.; Wen, Timothy; Huang, Christina; Cen, Steven; Mack, William J.; Acosta, Frank L.

doi:10.1016/j.jocn.2015.02.022

Cited by 13 publications

(11 citation statements)

References 36 publications

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“…Some studies have reported the absence of differences in the total hospitalization length or cost between weekend and non-weekend admissions [ 10 , 53 , 54 ]. By contrast, some studies have revealed that the weekend effect was observed in hospitalization length [ 39 , 41 , 42 , 45 , 55 ]. This study found that whether it is a medical center or a regional hospital, a public hospital, or a private hospital, the weekend effect appeared in the total length of initial hospitalization.…”

Section: Discussionmentioning

confidence: 99%

“…In their study in Canada, Saposnik et al [ 36 ] determined that the mortality rate of patients with stroke for weekend admissions was 17% higher than that for weekday admissions and that the early mortality rate for weekend admissions was higher than that for weekday admissions. Studies on the other types of patients with weekend admissions have also determined that the mortality rate for weekend admissions, mortality rate within 48 h after hospitalization, surgical intervention rate, incidence rate of adverse events, and mortality rate in emergency surgery were higher than patients admitted during weekdays [ 39 , 40 , 41 , 42 ]. A UK study revealed that the total risk of death in patients admitted through the emergency department on weekends was 10% higher than those admitted on weekdays [ 43 ] and that the mortality rate was 16% higher on Sunday than on Wednesday [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Influence of Admission Time on Health Care Quality and Utilization in Patients with Stroke: Analysis for a Possible July Effect and Weekend Effect

Liu

Kung

Chang

et al. 2021

IJERPH

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(1) Purpose: Undesirable health care outcomes could conceivably increase as a result of the entry of new, less experienced health care personnel into patient care during the month of July (the July effect) or as a result of the less balanced allocation of health care resources on weekends (the weekend effect). Whether these two effects were present in Taiwan’s National Health Insurance (NHI) system was investigated. (2) Methods: The current study data were acquired from the NHI Research Database. The research sample comprised ≥18-year-old patients diagnosed as having a stroke for the first time from 1 January 2006 to 30 September 2012. The mortality rate within 30 days after hospitalization and readmission rate within 14 days after hospital discharge were used as health care quality indicators, whereas health care utilization indicators were the total length and cost of initial hospitalization. (3) Results: The results revealed no sample-wide July effect with regard to the four indicators among patients with stroke. However, an unexpected July effect was present among in-patients in regional and public hospitals, in which the total lengths and costs of initial hospitalization for non-July admissions were higher than those for July admissions. Furthermore, the total hospitalization length for weekend admissions was 1.06–1.07 times higher than that for non-weekend admissions; the total hospitalization length for weekend admissions was also higher than that for weekday admissions during non-July months. Thus, weekend admission did not affect the health care quality of patients with stroke but extended their total hospitalization length. (4) Conclusions: Consistent with the NHI’s general effectiveness in ensuring fair, universally accessible, and high-quality health care services in Taiwan, the health care quality of patients examined in this study did not vary significantly overall between July and non-July months. However, a longer hospitalization length was observed for weekend admissions, possibly due to limitations in personnel and resource allocations during weekends. These results highlight the health care efficiency of hospitals during weekends as an area for further improvement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Influence of Admission Time on Health Care Quality and Utilization in Patients with Stroke: Analysis for a Possible July Effect and Weekend Effect

Liu

Kung

Chang

et al. 2021

IJERPH

View full text Add to dashboard Cite

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“…Patients undergoing any of the 4 most common inpatient orthopaedic surgeries (TKA, THA, spinal fusion, or laminectomy) have been noted to experience HACs at a rate of 1.3% to 5.4% [92][93][94][95][96][97] . The most common HACs among this population are SSI, VTE, CA-UTI, and an inpatient fall or trauma, as reported in our previous article 2 .…”

Section: Discussionmentioning

confidence: 99%

Current Guidelines and Practice Recommendations to Prevent Hospital-Acquired Conditions After Major Orthopaedic Surgeries

et al. 2022

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In 2016, a total of 48,771 hospital-acquired conditions (HACs) were reported in U.S. hospitals. These incidents resulted in an excess cost of >$2 billion, which translates to roughly $40,000 per patient with an HAC.Current guidelines for the prevention of venous thromboembolism and surgical site infection consist primarily of antithrombotic prophylaxis and antiseptic technique, respectively.The prevention of catheter-associated urinary tract infection (CA-UTI) and in-hospital falls and trauma is done best via education. In the case of CA-UTI, this consists of training staff about the indications for catheters and their timely removal when they are no longer necessary, and in the case of in-hospital falls and trauma, advising the patient and family about the patient’s fall risk and communicating the fall risk to the health-care team.Blood incompatibility is best prevented by implementation of a pretransfusion testing protocol. Pressure ulcers can be prevented via patient positioning, especially during surgery, and via postoperative skin checks.

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“…Existing evidence agrees with our findings: Weekend admission is associated with an increase in cost and length of stay [19], with an increased length of stay contributing to the higher cost. In addition, weekend admission is associated with an increased hospital-acquired condition rate [20,21]. According to the Centers for Medicaid and Medicare Services, hospital-acquired conditions (HACs) are preventable adverse events that do not qualify for reimbursement of resulting hospitals costs [20].…”

Section: Discussionmentioning

confidence: 99%

A Supervised Pattern Analysis of the Length of Stay for Hip Replacement Admissions

et al. 2019

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Hip replacement is the most common surgical procedure among Medicare patients in the US and worldwide. The hospital length of stay (LOS) for hip replacement admissions is therefore important to be controlled, contributing to savings for hospitals. This study combined medical claims and hospital structure and service data to examine LOS fluctuations and trends, and admission distribution patterns, during weekdays, for hip replacement cases. The study furthermore examined associations of these patterns with the LOS performance. Most hospitals were found to admit hip replacement cases at the start of the week (Monday through Wednesday). There is an upward LOS trend as we approach late weekday admissions. Multiple linear regression analysis showed that LOS weekday inconsistencies, a large proportion of hip replacement admissions on Thursday and Friday, the government ownership status, the bed size, and the critical access status are associated with an increased LOS. On the other hand, the rate of hip replacement admissions over total ones, and the hospital being accredited, are associated with a lower LOS. Findings stress out the need for hospitals to maintain an effective and balanced distribution of hip replacement admissions, evenly during the week, and the need for standardized case management, to avoid practice variability and, therefore, LOS fluctuations for their hip replacement cases.

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Evaluation of weekend admission on the prevalence of hospital acquired conditions in patients receiving thoracolumbar fusions

Cited by 13 publications

References 36 publications

Influence of Admission Time on Health Care Quality and Utilization in Patients with Stroke: Analysis for a Possible July Effect and Weekend Effect

Influence of Admission Time on Health Care Quality and Utilization in Patients with Stroke: Analysis for a Possible July Effect and Weekend Effect

Current Guidelines and Practice Recommendations to Prevent Hospital-Acquired Conditions After Major Orthopaedic Surgeries

A Supervised Pattern Analysis of the Length of Stay for Hip Replacement Admissions

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