Health Policy Manag.  2019 Jun;29(2):237-244. 10.4332/KJHPA.2019.29.2.237.

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

• Lee SA
• Park EC
• Shin J
• Ju YJ
• Lee HY

• KMID: 2453175
• DOI: http://doi.org/10.4332/KJHPA.2019.29.2.237

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.

Keyword

Hospitalization; Quality of health care; Hospital mortality; Hospital emergency service

MeSH Terms

Cardiovascular Diseases
Emergency Service, Hospital
Hospital Mortality*
Hospitalization
Humans
Insurance, Health
Korea*
Length of Stay
Mortality
Quality of Health Care