The effect of the weekend upon admissions to General Medicine

Potezny, Tessa; Horwood, Chris; Hakendorf, Paul; Thompson, Campbell

doi:10.1111/jep.12953

Cited by 4 publications

(4 citation statements)

References 15 publications

(16 reference statements)

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“…Although the variability in overall activity statewide is striking, individual hospitals may have quite different experiences. Additionally, the data set is only from New York State; there may be some differences in other states based on hospital and patient characteristics, although the findings here are consistent with experience elsewhere [9][10][11][12][13][14][15][16][17]. As this study did not include pediatric, psychiatric, or obstetric patients, the findings are not generalizable to these populations.…”

Section: Limitationsmentioning

confidence: 48%

“…Previous studies have shown that elective or scheduled admissions drive the variability of day-to-day admissions, with most elective admissions occurring at the beginning of the week. Studies have also shown fewer discharges on the weekend and increased LOS for patients who are discharged after the weekend [9][10][11][12][13][14][15][16][17]. However, these studies were conducted in only one or a few hospitals, studied certain diagnoses, and did not include both medical and surgical cases.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, this study examines whether the variability is due to emergency admissions, which cannot be controlled, or elective (non-emergency) admissions, which by their nature are schedulable and controllable. Previous studies have demonstrated variability in admission rates throughout the week, with fewer discharges occurring on weekends and increased LOS for patients discharged after the weekend [9][10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An Analysis of New York Data: Fluctuations in Hospital Capacity Are Driven by Variability in Elective Admissions and Discharge Activity

Heslin,

Henry,

Litvak

et al. 2024

Cureus

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Background Hospital overcrowding compromises patient safety. The contribution of variability in admissions and discharges to overall hospital capacity needs to be quantified. This study describes the statewide day-to-day fluctuation in the volume of hospitalized patients, the variability and pattern of hospital admissions and discharges throughout the week, and the contribution of Emergency Department (ED) vs. elective (non-ED) admissions and discharges to the overall variability in the system across the week. Methodology This is a retrospective analysis of the New York State Statewide Planning and Research Cooperative System database, in which all New York healthcare facilities submit patient-level data monthly. The study period was from January 01 to December 31, 2015. Outcomes included total volumes of admissions and discharges and length of stay sorted by patient origin (ED vs. non-ED admits (elective)) and service type (medicine vs. surgery) by day of the week. Results We studied 1,692,090 hospital admissions. Admissions were highest on Mondays and Tuesdays and steadily decreased throughout the week. There was little variability in the ED admissions throughout the week. Surgical elective admissions had significant variability throughout the week, with higher admissions at the beginning of the week. There was a significant difference (p < 0.01) between admissions on weekdays vs. weekends. Discharges increased from Monday to Friday, with a dramatic drop on the weekends, for both ED and elective pathways. Systemwide, on Monday, hospitals were 21% above the mean volume, and on Fridays, hospitals were 32% below the mean volume. Conclusions Overall hospital capacity shows dramatic variability throughout the week, driven primarily by elective admissions and discharges from any source throughout the week. Because elective admissions are schedulable, hospitals can reduce variability by smoothing scheduling. Increased weekend discharges will also improve capacity.

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Section: Limitationsmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An Analysis of New York Data: Fluctuations in Hospital Capacity Are Driven by Variability in Elective Admissions and Discharge Activity

Heslin,

Henry,

Litvak

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

“…The most important source for creating evidence-based information that will increase the quality of healthcare service is health information technology infrastructure. Most studies in the literature are based on surveys, direct observations, or retrospective calculations from records of wait times 13,[19][20][21][22] . According to a study published in 2017, the studies on the calculation of wait times in hospitals based 1on the process records of health service delivery are very rare 1 .…”

Section: Introductionmentioning

confidence: 99%

Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week

Özen,

Köse,

Yıgıt

et al. 2024

Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi

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The time spent waiting is an important problem regarding patient satisfaction and hospital efficiency, and increases the need for evidence-based information for management to make decisions towards a solution. This study aims to examine the process flows in hospitals based on actual data with the intent to design a better service delivery system and set a pattern in terms of determining the congestion in the process and planning the necessary improvements. For this purpose, the data sets for 2016 pertaining to secondary and tertiary level hospitals in Turkey, which are stored in the central physician appointment system (CPAS), are investigated. The data is analyzed through pre-processing, cleaning and transformation stages. Congestion patterns are determined by days and hours spent in hospitals. Monday is found to be the day with the highest patient density and the longest wait time in Turkish hospitals. Additionally, when analyzed by working hours, it is determined that the first 2 hours in the morning (9.00 a.m. to 11.00 a.m.) is the period when most patentse are examined. The lunchtime (between 12.00 p.m. - 1.00 p.m.) and the afternoon from 4.00 p.m. to 5.00 p.m. are the times when patient density is the lowest, but average wait time is the longest. Turkish hospitals are found to be particularly congested on some days and during some hours regarding patient wait times. Thus, policy recommendations can be developed specifically to the days and times when congestion patterns are identified rather than suggesting a general policy. This study is the most comprehensive study conducted in Turkey through process data. The working model is reproducible in different countries and regions.

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

Rappaport

VanderVennen

Monroe

et al. 2021

Hospital Pediatrics

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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.

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The effect of the weekend upon admissions to General Medicine

Abstract: General Medicine has an inpatient mortality unaffected by the DOWOA. Care efficiency, however, follows a weekly cycle. The "weekend effect" for General Medical inpatients is a prolongation in their IPLOS as a result of fewer weekend discharges.

Cited by 4 publications

References 15 publications

An Analysis of New York Data: Fluctuations in Hospital Capacity Are Driven by Variability in Elective Admissions and Discharge Activity

An Analysis of New York Data: Fluctuations in Hospital Capacity Are Driven by Variability in Elective Admissions and Discharge Activity

Analysis of Density and Patient Wait Times In Terms of System Management In Turkish Hospitals: Setting A Pattern by Days and Hours of The Week

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

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