COMPARATIVE STUDY
JOURNAL ARTICLE

Weekend hospital admission and discharge for heart failure: association with quality of care and clinical outcomes

Tamara B Horwich, Adrian F Hernandez, Li Liang, Nancy M Albert, Kenneth A Labresh, Clyde W Yancy, Gregg C Fonarow et al.
American Heart Journal 2009, 158 (3): 451-8
19699870

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.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
19699870
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"