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Restricted weekend service inappropriately delays discharge after acute myocardial infarction

A M Varnava1, J E C Sedgwick, A Deaner

  • 1Department of Cardiology, London Chest Hospital, Bonner Road, London E2, UK. avarnava@sghms.ac.uk

Heart (British Cardiac Society)
|February 16, 2002
PubMed

Insights

Hospital discharge for myocardial infarction patients is safe, but weekend discharge is avoided. This leads to longer hospital stays, not based on clinical need but admission day, impacting bed occupancy.

Area of Science:

  • Cardiology
  • Healthcare Management

Background:

  • Early discharge after myocardial infarction (MI) is safe and feasible.
  • Identifying discharge delays is crucial for improving patient care and reducing hospital bed occupancy.

Purpose of the Study:

  • To investigate if restricted weekend hospital services delay patient discharge.
  • To analyze the impact of admission day on length of stay for acute myocardial infarction patients.

Main Methods:

  • Prospective cohort study.
  • Analysis of 2541 consecutive acute myocardial infarction patients over 12 years in three district hospitals.

Main Results:

  • Clinical factors like age, sex, and infarct severity influenced length of stay.
  • Discharge occurred significantly less often on weekends (p=0.0001).
  • Patients admitted early in the week were discharged on Friday, while Tuesday-Saturday admissions avoided weekend discharge, extending stays.

Conclusions:

  • Discharge decisions for myocardial infarction patients were influenced by clinical risk but also inappropriately by the day of the week.
  • Weekend discharge avoidance led to variable lengths of stay, primarily determined by admission day rather than clinical necessity.
Abstract

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