Effects of night-time and weekend admissions on in-hospital mortality in acute myocardial infarction patients in Japan

Seiko Mizuno, Susumu Kunisawa, Noriko Sasaki, Kiyohide Fushimi and Yuichi Imanaka

PLOS ONE, 2018, vol. 13, issue 1, 1-10

Abstract: Background: Patients admitted to hospital during off-hours may experience poorer quality of care and clinical outcomes. However, few studies have examined the variations in clinical processes and outcomes across admission times and days of the week in acute myocardial infarction (AMI) patients. This study aimed to comparatively analyze the effect of weekend and weekday admissions stratified by admission time on in-hospital mortality in AMI patients. Methods and results: Using a large nationwide administrative database, we analyzed 103,908 AMI patients admitted to 639 Japanese acute care hospitals between April 2011 and March 2015. We divided patients into the following 4 groups: weekday daytime admissions, weekday night-time admissions, weekend daytime admissions, and weekend night-time admissions. A hierarchical logistic regression model was used to comparatively examine in-hospital mortality among the groups after adjusting for age, sex, ambulance use, Killip class, comorbidities, and the number of cardiologists in the admitting hospital. In addition, we also calculated and compared the adjusted odds ratios of various AMI therapies among the groups. The in-hospital mortality rate of weekend daytime admissions was higher than those admitted during other times (weekday daytime: 6.8%; weekday night-time; 6.5%, weekend daytime; 7.6%; weekend night-time: 6.6%; P

Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0191460

DOI: 10.1371/journal.pone.0191460

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