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Pediatric weekend admission and increased unplanned readmission rates

Katherine A Auger1, Matthew M Davis2

  • 1General Pediatrics, Division of Hospital Medicine and James M. Anderson Center for Healthcare Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Journal of Hospital Medicine
|September 19, 2015
PubMed

Insights

Children admitted to the hospital on weekends face higher risks of unplanned 30-day readmissions. This "weekend effect" in pediatric care may stem from initial treatment variations, not discharge planning.

Area of Science:

  • Pediatric Hospital Medicine
  • Healthcare Quality and Safety
  • Health Services Research

Background:

  • The "weekend effect" describes worse outcomes for adult patients hospitalized on weekends.
  • Limited research exists on the weekend effect specifically within pediatric populations.
  • Understanding weekend admission impacts on pediatric readmissions is crucial for improving care.

Purpose of the Study:

  • To investigate the association between weekend hospital admission and discharge and unplanned 30-day readmissions in children.
  • To determine if the weekend effect observed in adults is also present in pediatric hospitalizations.

Main Methods:

  • Retrospective analysis of 55,383 hospitalizations at a tertiary care children's hospital.
  • Logistic regression was used to assess the relationship between weekend admission/discharge and 30-day unplanned readmissions.
  • Analyses were adjusted for patient complexity (chronic conditions, technology dependency) and length of stay.

Main Results:

  • The overall 30-day unplanned readmission rate was 10.3%.
  • Weekend admission was significantly associated with higher odds of unplanned 30-day readmission (aOR = 1.09; 95% CI: 1.004–1.18).
  • Weekend discharge was not significantly associated with 30-day readmission.

Conclusions:

  • Pediatric patients admitted on weekends exhibit increased rates of 30-day unplanned readmissions compared to weekday admissions.
  • Findings suggest potential differences in initial clinical management during weekend admissions contribute to higher readmission rates.
  • The weekend effect in children appears related to admission care rather than discharge processes.

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