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Weekend hospital admission and discharge for heart failure: association with quality of care and clinical outcomes.
Am Heart J. 2009 Sep; 158(3):451-8.AH

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.

Authors+Show Affiliations

Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles, CA 90095-1679, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19699870

Citation

Horwich, Tamara B., et al. "Weekend Hospital Admission and Discharge for Heart Failure: Association With Quality of Care and Clinical Outcomes." American Heart Journal, vol. 158, no. 3, 2009, pp. 451-8.
Horwich TB, Hernandez AF, Liang L, et al. Weekend hospital admission and discharge for heart failure: association with quality of care and clinical outcomes. Am Heart J. 2009;158(3):451-8.
Horwich, T. B., Hernandez, A. F., Liang, L., Albert, N. M., Labresh, K. A., Yancy, C. W., & Fonarow, G. C. (2009). Weekend hospital admission and discharge for heart failure: association with quality of care and clinical outcomes. American Heart Journal, 158(3), 451-8. https://doi.org/10.1016/j.ahj.2009.06.025
Horwich TB, et al. Weekend Hospital Admission and Discharge for Heart Failure: Association With Quality of Care and Clinical Outcomes. Am Heart J. 2009;158(3):451-8. PubMed PMID: 19699870.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Weekend hospital admission and discharge for heart failure: association with quality of care and clinical outcomes. AU - Horwich,Tamara B, AU - Hernandez,Adrian F, AU - Liang,Li, AU - Albert,Nancy M, AU - Labresh,Kenneth A, AU - Yancy,Clyde W, AU - Fonarow,Gregg C, AU - ,, Y1 - 2009/08/04/ PY - 2009/04/08/received PY - 2009/06/16/accepted PY - 2009/8/25/entrez PY - 2009/8/25/pubmed PY - 2009/10/9/medline SP - 451 EP - 8 JF - American heart journal JO - Am. Heart J. VL - 158 IS - 3 N2 - 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. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/19699870/Weekend_hospital_admission_and_discharge_for_heart_failure:_association_with_quality_of_care_and_clinical_outcomes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(09)00480-3 DB - PRIME DP - Unbound Medicine ER -