Trends and Outcomes in Elective Pediatric Surgery During Weekends

Area of Science:

• Pediatric Surgery
• Hospital Operations
• Healthcare Management

Background:

• Operating room availability is a key constraint for elective surgical scheduling.
• Utilizing weekends for elective surgeries could enhance hospital capacity.
• Balancing increased capacity with practical and safety considerations is crucial.

Purpose of the Study:

• To analyze trends in elective pediatric surgeries performed on weekends.
• To compare outcomes, including complications and costs, of weekend versus weekday elective pediatric surgeries.

Main Methods:

• Retrospective cohort study using the Pediatric Health Information System database (2016-2019).
• Analysis of six common elective pediatric surgeries across 38 hospitals.
• Mann-Kendall trend test for temporal trends and multivariable regression for outcome comparisons.

Main Results:

• Only 0.15% of 233,266 elective surgeries occurred on weekends, with stable proportions over time.
• No significant differences in surgical complications (aOR 1.59) or mortality were found between weekend and weekday surgeries.
• Weekend surgeries incurred a small additional cost (β $312) compared to weekday procedures.

Conclusions:

• Elective pediatric surgeries on weekends are infrequent and stable.
• Weekend surgeries do not significantly increase complications or mortality.
• Further assessment is needed to explore patient/provider satisfaction, resource costs, and case selection for safe expansion of weekend surgical services.