Discharge and Readmission

Traditionally, Americans work a 40-hour week and consider weekends and after-hours as “off-time.” While hospitals are often not as fully staffed during weekends and holidays, patients arrive at all hours and staff must be available to assist these patients. As an ambulatory cardiac monitor provider, ReactDx understands patient needs and the importance of proper patient care.

Recent readmission rates have risen 22% after major cardiac surgery, which has led administrators, physicians, and researchers to closely examine the causatives of the increase. According to many healthcare professionals, one component could possibly be the aforementioned “weekend effect phenomenon” when patients were discharged outside normal business hours. To that end, several studies have been reviewed.

A recent study published in The Annals of Thoracic Surgery posited the question as to whether patients discharged on weekends or holidays had an elevated rate of readmission than patients discharged on weekdays. Readmission was defined at returning any point within 30 days after discharge and did not focus solely on one cause for readmission; all reasons were considered. Patients in the survey were admitted for cardiothoracic surgery.

The patient cohort included 4,877 adults registered with the Society of Thoracic Surgeons database who opted for elective cardiac operations. Researchers focused on patients admitted between 2008 and 2016; their objective was to assess potentially modifiable variables during patient discharge following major cardiac surgery. Comorbidities, operative performance, and postoperative complications were considered when adjusting for this multivariable logistic regression study model.

In total, patients averaged an 11.3% readmission rate (11.4% for weekend vs 11.0% for weekday) with 19.6% of those patients released on weekends or holidays. Readmission rates climbed when patients were discharged to a secondary facility (16.7%) rather than being discharged directly home (12.7%). Patients discharged to facilities increased during normal business hours (15.0%) when compared to weekends and holidays (5.7%).

Researchers determined weekend and holiday discharge dates did not correlate with readmission rates, and the push to reallocate administrative and auxiliary staff to accommodate discharges on weekends and holidays may not be necessary. Stay apprised of the latest news by reading ReactDx’s blogs and calling us at 800-23-HEART to learn more about our top-of-the-line ambulatory cardiac monitors.

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