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http://dx.doi.org/10.4332/KJHPA.2019.29.2.237

Association between Weekend Admission and In-hospital Mortality among Cardiovascular Patients in Korea  

Lee, Sang Ah (Research and Analysis Team, National Health Insurance Service Ilsan Hospital)
Park, Eun-Cheol (Institute of Health Services Research, Yonsei University)
Shin, Jaeyong (Institute of Health Services Research, Yonsei University)
Ju, Yeong Jun (Institute of Health Services Research, Yonsei University)
Lee, Hoo-Yeon (Department of Social Medicine, Dankook University College of Medicine)
Publication Information
Health Policy and Management / v.29, no.2, 2019 , pp. 237-244 More about this Journal
Abstract
Background: Weekend admission is known for having association with increased mortality attributed by poor quality of care and severe patients. We investigated the association between hospital admission on weekends and the in-hospital mortality rates of patients with cardiovascular disease. Furthermore, we examined this association stratified by admission via emergency room or not. Methods: We analyzed claim data provided by the Health Insurance Review & Assessment in 2013. In total, 80,817 cardiovascular patients were included in this study, which treated in-hospital mortality (early and during total length of stay) as a dependent variable. A generalized linear mixed effects model was used. We conducted subgroup analyses stratified by admission via emergency room or not. Results: Patients who admitted on weekend showed higher in-hospital mortality both early (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.23-1.78) and during total length of stay (OR, 1.17; 95% CI, 1.02-1.33) compared to those admitted on weekdays. Patients who were admitted to the hospital on a weekend by emergency room were more likely to experience early in-hospital mortality compared to those admitted on weekdays. Furthermore, we found that patients not admitted to the hospital through the emergency department were more likely to experience both early and total length of stay in-hospital mortality. Conclusion: Our study shows higher in-hospital mortality rates for cardiovascular patients admitted on weekends. Efforts to improve the quality of care on weekend are important to mitigate the 'weekend effect' and improve patient outcomes.
Keywords
Hospitalization; Quality of health care; Hospital mortality; Hospital emergency service;
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