Weekend Admissions for Somatic Symptom and Related Disorders and Length of Stay

Abstract

OBJECTIVES: To evaluate whether admission on weekends affects the length of stay (LOS) for patients hospitalized with somatic symptom and related disorders (SSRDs). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Clinical progress note: Management of somatic symptom and related disorders in pediatric inpatients

“…The importance of such interdisciplinary efforts is further supported by a subsequent study showing a greater length of stay for patients with SSRDs admitted on a weekend compared to weekdays, suspected to be a result of limited weekend multidisciplinary care availability. 14 Creating an SSRD-informed care culture involves educating providers on appropriate diagnosis and terminology, minimizing dualistic attitudes toward somatic symptoms, and practicing a multidisciplinary approach to care. 15 F I G U R E 1 Summary of common themes of established clinical pathways somatic symptoms and related disorders.…”

School Absenteeism Longer Than Two Weeks Is a Red Flag of Somatic Symptom and Related Disorders in Hospitalised Children and Adolescents: A Matched Cohort Study

“…In the United States, this type of disorder is estimated to contribute 15–20% of the annual paediatric health care cost burden, requiring numerous investigations and hospital admissions. Although prevalence data are limited, estimates range from 17% to 50% of school-age children and adolescents, and potentially 20% of children between the ages of 3 and 5 have experienced or have SSRDs [ 6 ]. The recent pandemic also affected the occurrence of this type of disorder among adolescents, and its psychological impact should not be underestimated.…”