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Impact of enforcing the Labour Ordinance, with 1-in-7-day off for hospital doctors, on weekend hospital discharge rate.
J Public Health (Oxf). 2005 Jun; 27(2):189-91.JP

Abstract

BACKGROUND

After enforcing the Labour Ordinance, hospital doctors must have 1 day off-work every week. In this study, we aimed to evaluate its impact on the discharge pattern from an acute medical hospital.

METHODS

We undertook a hospital-based ecologic study with before-after design using the clinical management database of patient discharge records of all acute medical wards in a hospital from January to March 2002 (1 year before new system) and from January to March 2004 (1 year after restricted weekend service). The main outcome measures were the daily discharge rates for the two periods. The odds of being discharged on a Saturday were estimated by multivariate analyses.

RESULTS

The number of patient discharge on a Saturday was substantially lower in 2004 as compared to 2002 (47.5 +/- 8.5 per Saturday versus 70.5 +/- 11.1 per Saturday, respectively, p < 0.001). A statistically significant decreased trend was noted in the weekend discharge rate in 2002 and 2004 (Poisson p-value for change in discharge rate, p < 0.001). On the other hand, the number of patient discharges on weekdays did not differ between the two periods. Consistently fewer patients were being discharged on Sundays and Mondays as compared to the rest of the week days in both periods. Compared with study period 2002, patients hospitalized in 2004 (with limited weekend service) had significantly lower multivariate-adjusted odds of being discharged on a Saturday (odds ratio of 0.70; 95 percent confidence interval 0.72-0.89, p < 0.0001).

CONCLUSIONS

Length of hospital stay is influenced by the health care system delivery apart from clinical factors. Restricted weekend services in an acute medical hospital setting substantially lengthen the hospital stay, and might therefore entail a major financial burden.

Authors+Show Affiliations

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR, China.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15774562

Citation

Chow, Kai Ming, and Cheuk Chun Szeto. "Impact of Enforcing the Labour Ordinance, With 1-in-7-day Off for Hospital Doctors, On Weekend Hospital Discharge Rate." Journal of Public Health (Oxford, England), vol. 27, no. 2, 2005, pp. 189-91.
Chow KM, Szeto CC. Impact of enforcing the Labour Ordinance, with 1-in-7-day off for hospital doctors, on weekend hospital discharge rate. J Public Health (Oxf). 2005;27(2):189-91.
Chow, K. M., & Szeto, C. C. (2005). Impact of enforcing the Labour Ordinance, with 1-in-7-day off for hospital doctors, on weekend hospital discharge rate. Journal of Public Health (Oxford, England), 27(2), 189-91.
Chow KM, Szeto CC. Impact of Enforcing the Labour Ordinance, With 1-in-7-day Off for Hospital Doctors, On Weekend Hospital Discharge Rate. J Public Health (Oxf). 2005;27(2):189-91. PubMed PMID: 15774562.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of enforcing the Labour Ordinance, with 1-in-7-day off for hospital doctors, on weekend hospital discharge rate. AU - Chow,Kai Ming, AU - Szeto,Cheuk Chun, Y1 - 2005/03/17/ PY - 2005/3/19/pubmed PY - 2005/10/21/medline PY - 2005/3/19/entrez SP - 189 EP - 91 JF - Journal of public health (Oxford, England) JO - J Public Health (Oxf) VL - 27 IS - 2 N2 - BACKGROUND: After enforcing the Labour Ordinance, hospital doctors must have 1 day off-work every week. In this study, we aimed to evaluate its impact on the discharge pattern from an acute medical hospital. METHODS: We undertook a hospital-based ecologic study with before-after design using the clinical management database of patient discharge records of all acute medical wards in a hospital from January to March 2002 (1 year before new system) and from January to March 2004 (1 year after restricted weekend service). The main outcome measures were the daily discharge rates for the two periods. The odds of being discharged on a Saturday were estimated by multivariate analyses. RESULTS: The number of patient discharge on a Saturday was substantially lower in 2004 as compared to 2002 (47.5 +/- 8.5 per Saturday versus 70.5 +/- 11.1 per Saturday, respectively, p < 0.001). A statistically significant decreased trend was noted in the weekend discharge rate in 2002 and 2004 (Poisson p-value for change in discharge rate, p < 0.001). On the other hand, the number of patient discharges on weekdays did not differ between the two periods. Consistently fewer patients were being discharged on Sundays and Mondays as compared to the rest of the week days in both periods. Compared with study period 2002, patients hospitalized in 2004 (with limited weekend service) had significantly lower multivariate-adjusted odds of being discharged on a Saturday (odds ratio of 0.70; 95 percent confidence interval 0.72-0.89, p < 0.0001). CONCLUSIONS: Length of hospital stay is influenced by the health care system delivery apart from clinical factors. Restricted weekend services in an acute medical hospital setting substantially lengthen the hospital stay, and might therefore entail a major financial burden. SN - 1741-3842 UR - https://www.unboundmedicine.com/medline/citation/15774562/Impact_of_enforcing_the_Labour_Ordinance_with_1_in_7_day_off_for_hospital_doctors_on_weekend_hospital_discharge_rate_ L2 - https://academic.oup.com/jpubhealth/article-lookup/doi/10.1093/pubmed/fdi022 DB - PRIME DP - Unbound Medicine ER -