Health Policy Manag.  2019 Jun;29(2):228-236. 10.4332/KJHPA.2019.29.2.228.

The Impact of Weekend Admission and Patient Safety Indicator on 30-Day Mortality among Korean Long-Term Care Insurance Beneficiaries

• Shin J
• Kim JH

• KMID: 2453174
• DOI: http://doi.org/10.4332/KJHPA.2019.29.2.228

Abstract

BACKGROUND
This study investigates the impact of weekend admission with a patient safety indicator (PSI) on 30-day mortality among long-term insurance beneficiaries.
METHODS
Data were obtained from the National Health Insurance Service-Senior claim database from 2002 to 2013. To obtain unbiased estimates of odds ratio, we used a nested case-control study design. The cases were individuals who had a 30-day mortality event after their last medical utilization, while controls were selected by incidence density sampling based on age and sex. We examined the interaction between the main independent variables of weekend admission and PSI by categorizing cases into four groups: weekend admission/PSI, weekend admission/non-PSI, weekday admission/PSI, and weekday admission/non-PSI.
RESULTS
Of the 83,400 individuals in the database, there were 20,854 cases (25.0%) and 62,546 controls (75.0%). After adjusting for socioeconomic, health status, seasonality, and hospital-level factors, the odds ratios (ORs) of 30-day mortality for weekend admission/PSI (OR, 1.484; 95% confidence interval [CI], 1.371-1.606) and weekday admission/PSI (OR, 1.357; 95% CI, 1.298-1.419) were greater than for patients with weekday admission/non-PSI.
CONCLUSION
This study indicated that there is an increased risk of mortality after weekend admission among patients with PSI as compared with patients admitted during the weekday without a PSI. Therefore, our findings suggest that recognizing these different patterns is important to identify at-risk diagnosis to minimize the excess mortality associated with weekend admission in those with PSI.

Keyword

Admission; Ageing; Mortality; Safety

MeSH Terms

Case-Control Studies
Diagnosis
Humans
Incidence
Insurance Benefits
Insurance, Long-Term Care*
Long-Term Care*
Mortality*
National Health Programs
Odds Ratio
Patient Safety*
Seasons