- Title
- Weekend hospital discharge is associated with suboptimal care and outcomes: an observational Australian stroke clinical registry study
- Creator
- Kilkenny, Monique F.; Lannin, Natasha A.; Crosby, Vanessa; Gardner, Michele; Rois-Gnecco, Juan; Thijs, Vincent; Anderson, Craig S.; Donnan, Geoffrey; Middleton, Sandy; Cadilhac, Dominique A.; Levi, Chris; Faux, Steven G.; Dewey, Helen M.; Grimley, Rohan; Hill, Kelvin; Grabsch, Brenda; Kim, Jossup; Hand, Peter
- Relation
- International Journal of Stroke Vol. 14, Issue 4, p. 430-438
- Publisher Link
- http://dx.doi.org/10.1177/1747493018806165
- Publisher
- Sage
- Resource Type
- journal article
- Date
- 2019
- Description
- Background: The quality of stroke care may diminish on weekends. Aims: We aimed to compare the quality of care and outcomes for patients with stroke/transient ischemic attack discharged on weekdays compared with those discharged on weekends. Methods: Data from the Australian Stroke Clinical Registry from January 2010 to December 2015 (n = 45 hospitals) were analyzed. Differences in processes of care by the timing of discharge are described. Multilevel regression and survival analyses (up to 180 days postevent) were undertaken. Results: Among 30,649 registrants, 2621 (8.6%) were discharged on weekends (55% male; median age 74 years). Compared to those discharged on weekdays, patients discharged on weekends were more often patients with a transient ischemic attack (weekend 35% vs. 19%; p < 0.001) but were less often treated in a stroke unit (69% vs. 81%; p < 0.001), prescribed antihypertensive medication at discharge (65% vs. 71%; p < 0.001) or received a care plan if discharged to the community (47% vs. 53%; p < 0.001). After accounting for patient characteristics and clustering by hospital, patients discharged on weekends had a 1 day shorter length of stay (coefficient = -1.31, 95% confidence interval [CI] = -1.52, -1.10), were less often discharged to inpatient rehabilitation (aOR = 0.39, 95% CI = 0.34, 0.44) and had a greater hazard of death within 180 days (hazard ratio = 1.22, 95% CI = 1.04, 1.42) than those discharged on weekdays. Conclusions: Patients with stroke/transient ischemic attack discharged on weekends were more likely to receive suboptimal care and have higher long-term mortality. High quality of stroke care should be consistent irrespective of the timing of hospital discharge.
- Subject
- weekend; weekday; quality care; clinical indicators; outcomes; stroke; transient ischemic attack; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1467640
- Identifier
- uon:47863
- Identifier
- ISSN:1747-4930
- Language
- eng
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