Implementation of a seven-day hospitalist program to improve the outcomes of the weekend admission: A retrospective before-after study in Taiwan
Patients admitted during weekends may have worse outcomes than those during weekdays. Adjusting the practice of senior physicians over weekends may reduce the weekend effect. A controlled before-after study, with propensity score matching (PSM) for potential confounding variables, to compare outcome...
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| Veröffentlicht in: | PloS one 2018-03, Vol.13 (3), p.e0194833-e0194833 |
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| creator | Hsu, Nin-Chieh Huang, Chun-Che Shu, Chin-Chung Yang, Ming-Chin |
| description | Patients admitted during weekends may have worse outcomes than those during weekdays. Adjusting the practice of senior physicians over weekends may reduce the weekend effect.
A controlled before-after study, with propensity score matching (PSM) for potential confounding variables, to compare outcomes between weekday and weekend admissions.
A 2000-bed medical centre in Taiwan.
Hospitalised general medicine patients cared for by traditional internal medicine teams (pre-intervention cohort) and those cared for by hospitalists after introducing a seven-day hospitalist program in the first six-month (post-intervention cohort) and following three-year periods.
Proportion of intensive care unit (ICU) admissions, cardiopulmonary resuscitation (CPR) events, and in-hospital mortality.
The pre-intervention cohort included 982 patients. Significantly higher mortality rates (11.3% vs. 6.2%, p = 0.032) were recorded in the case of weekend admissions, with similar proportions of ICU admission and CPR events. The post-intervention cohort included 601 patients. No significant difference was recorded in any of the main outcomes between weekday and weekend admissions. PSM for pre-intervention and post-intervention cohort showed shorter LOS after intervention, with no difference in ICU admission, CPR, and morality for the weekday and weekend admissions, respectively. The three-year cohort that followed, consisting of 3315 patients, showed no difference of outcomes between weekday and weekend admissions. After PSM, there were no significant differences in ICU admission rates (1.0% vs. 1.8%), CPR (0.3% vs. 0.2%) events and hospital mortality rates (8.1% vs. 8.5%), when weekday and weekend admissions were compared.
The seven-day hospitalist program shows potential in providing equally safe care for both weekday and weekend general medicine admissions with sustainable development. |
| doi_str_mv | 10.1371/journal.pone.0194833 |
| format | Article |
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A controlled before-after study, with propensity score matching (PSM) for potential confounding variables, to compare outcomes between weekday and weekend admissions.
A 2000-bed medical centre in Taiwan.
Hospitalised general medicine patients cared for by traditional internal medicine teams (pre-intervention cohort) and those cared for by hospitalists after introducing a seven-day hospitalist program in the first six-month (post-intervention cohort) and following three-year periods.
Proportion of intensive care unit (ICU) admissions, cardiopulmonary resuscitation (CPR) events, and in-hospital mortality.
The pre-intervention cohort included 982 patients. Significantly higher mortality rates (11.3% vs. 6.2%, p = 0.032) were recorded in the case of weekend admissions, with similar proportions of ICU admission and CPR events. The post-intervention cohort included 601 patients. No significant difference was recorded in any of the main outcomes between weekday and weekend admissions. PSM for pre-intervention and post-intervention cohort showed shorter LOS after intervention, with no difference in ICU admission, CPR, and morality for the weekday and weekend admissions, respectively. The three-year cohort that followed, consisting of 3315 patients, showed no difference of outcomes between weekday and weekend admissions. After PSM, there were no significant differences in ICU admission rates (1.0% vs. 1.8%), CPR (0.3% vs. 0.2%) events and hospital mortality rates (8.1% vs. 8.5%), when weekday and weekend admissions were compared.
The seven-day hospitalist program shows potential in providing equally safe care for both weekday and weekend general medicine admissions with sustainable development.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0194833</identifier><identifier>PMID: 29579132</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Biology and Life Sciences ; Efficiency ; Health care facilities ; Health care policy ; Hospital administration ; Hospital admission and discharge ; Hospitalists ; Hospitals ; Inpatient care ; Internal medicine ; Intervention ; Laboratories ; Management ; Medical personnel ; Medical research ; Medicine ; Medicine and Health Sciences ; Morality ; Mortality ; Nurse practitioners ; Patient care ; Patients ; Physicians ; Quality ; Resuscitation ; Stroke ; Sustainable development ; Traditional medicine ; Workforce planning</subject><ispartof>PloS one, 2018-03, Vol.13 (3), p.e0194833-e0194833</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Hsu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Hsu et al 2018 Hsu et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c622t-78a9341b60b498b59c3bda482ce9fa5142908a27fda96c08d04575e0b19bca383</citedby><cites>FETCH-LOGICAL-c622t-78a9341b60b498b59c3bda482ce9fa5142908a27fda96c08d04575e0b19bca383</cites><orcidid>0000-0002-4997-1081</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868823/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5868823/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29579132$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Nanayakkara, Prabath W. B.</contributor><creatorcontrib>Hsu, Nin-Chieh</creatorcontrib><creatorcontrib>Huang, Chun-Che</creatorcontrib><creatorcontrib>Shu, Chin-Chung</creatorcontrib><creatorcontrib>Yang, Ming-Chin</creatorcontrib><title>Implementation of a seven-day hospitalist program to improve the outcomes of the weekend admission: A retrospective before-after study in Taiwan</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Patients admitted during weekends may have worse outcomes than those during weekdays. Adjusting the practice of senior physicians over weekends may reduce the weekend effect.
A controlled before-after study, with propensity score matching (PSM) for potential confounding variables, to compare outcomes between weekday and weekend admissions.
A 2000-bed medical centre in Taiwan.
Hospitalised general medicine patients cared for by traditional internal medicine teams (pre-intervention cohort) and those cared for by hospitalists after introducing a seven-day hospitalist program in the first six-month (post-intervention cohort) and following three-year periods.
Proportion of intensive care unit (ICU) admissions, cardiopulmonary resuscitation (CPR) events, and in-hospital mortality.
The pre-intervention cohort included 982 patients. Significantly higher mortality rates (11.3% vs. 6.2%, p = 0.032) were recorded in the case of weekend admissions, with similar proportions of ICU admission and CPR events. The post-intervention cohort included 601 patients. No significant difference was recorded in any of the main outcomes between weekday and weekend admissions. PSM for pre-intervention and post-intervention cohort showed shorter LOS after intervention, with no difference in ICU admission, CPR, and morality for the weekday and weekend admissions, respectively. The three-year cohort that followed, consisting of 3315 patients, showed no difference of outcomes between weekday and weekend admissions. After PSM, there were no significant differences in ICU admission rates (1.0% vs. 1.8%), CPR (0.3% vs. 0.2%) events and hospital mortality rates (8.1% vs. 8.5%), when weekday and weekend admissions were compared.
The seven-day hospitalist program shows potential in providing equally safe care for both weekday and weekend general medicine admissions with sustainable development.</description><subject>Biology and Life Sciences</subject><subject>Efficiency</subject><subject>Health care facilities</subject><subject>Health care policy</subject><subject>Hospital administration</subject><subject>Hospital admission and discharge</subject><subject>Hospitalists</subject><subject>Hospitals</subject><subject>Inpatient care</subject><subject>Internal medicine</subject><subject>Intervention</subject><subject>Laboratories</subject><subject>Management</subject><subject>Medical personnel</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Morality</subject><subject>Mortality</subject><subject>Nurse practitioners</subject><subject>Patient 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Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hsu, Nin-Chieh</au><au>Huang, Chun-Che</au><au>Shu, Chin-Chung</au><au>Yang, Ming-Chin</au><au>Nanayakkara, Prabath W. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implementation of a seven-day hospitalist program to improve the outcomes of the weekend admission: A retrospective before-after study in Taiwan</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-03-26</date><risdate>2018</risdate><volume>13</volume><issue>3</issue><spage>e0194833</spage><epage>e0194833</epage><pages>e0194833-e0194833</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Patients admitted during weekends may have worse outcomes than those during weekdays. Adjusting the practice of senior physicians over weekends may reduce the weekend effect.
A controlled before-after study, with propensity score matching (PSM) for potential confounding variables, to compare outcomes between weekday and weekend admissions.
A 2000-bed medical centre in Taiwan.
Hospitalised general medicine patients cared for by traditional internal medicine teams (pre-intervention cohort) and those cared for by hospitalists after introducing a seven-day hospitalist program in the first six-month (post-intervention cohort) and following three-year periods.
Proportion of intensive care unit (ICU) admissions, cardiopulmonary resuscitation (CPR) events, and in-hospital mortality.
The pre-intervention cohort included 982 patients. Significantly higher mortality rates (11.3% vs. 6.2%, p = 0.032) were recorded in the case of weekend admissions, with similar proportions of ICU admission and CPR events. The post-intervention cohort included 601 patients. No significant difference was recorded in any of the main outcomes between weekday and weekend admissions. PSM for pre-intervention and post-intervention cohort showed shorter LOS after intervention, with no difference in ICU admission, CPR, and morality for the weekday and weekend admissions, respectively. The three-year cohort that followed, consisting of 3315 patients, showed no difference of outcomes between weekday and weekend admissions. After PSM, there were no significant differences in ICU admission rates (1.0% vs. 1.8%), CPR (0.3% vs. 0.2%) events and hospital mortality rates (8.1% vs. 8.5%), when weekday and weekend admissions were compared.
The seven-day hospitalist program shows potential in providing equally safe care for both weekday and weekend general medicine admissions with sustainable development.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29579132</pmid><doi>10.1371/journal.pone.0194833</doi><tpages>e0194833</tpages><orcidid>https://orcid.org/0000-0002-4997-1081</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Biology and Life Sciences Efficiency Health care facilities Health care policy Hospital administration Hospital admission and discharge Hospitalists Hospitals Inpatient care Internal medicine Intervention Laboratories Management Medical personnel Medical research Medicine Medicine and Health Sciences Morality Mortality Nurse practitioners Patient care Patients Physicians Quality Resuscitation Stroke Sustainable development Traditional medicine Workforce planning |
| title | Implementation of a seven-day hospitalist program to improve the outcomes of the weekend admission: A retrospective before-after study in Taiwan |
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