Increased length of stay and costs associated with weekend admissions for failure to thrive.

Thompson RT, Bennett WE Jr, Finnell SM, Downs SM, Carroll AE.

Source

Children's Health Services Research, Section of Children’s Health Services Research, Clinical Utilization and Resource Efficiency (CURE) Group, Indiana University School of Medicine, Indianapolis, IN 46202, USA. rtthomps@iupui.edu

Abstract

OBJECTIVE:

To evaluate whether admission day of the week affects the length of stay (LOS) and health care costs for failure to thrive (FTT) admissions.

METHODS:

Administrative data were obtained for all children aged <2 2003-2011="" 23="" 332="" 42="" a="" admission.="" admission="" analysis.="" and="" billed="" characteristics="" code="" costs="" day="" demographic="" diagnoses="" diagnosis="" discharge="" during="" each="" for="" freestanding="" from="" ftt="" hospitals.="" laboratory="" linear="" los="" number="" obtained="" of="" p="" per="" poisson="" primary="" procedure="" radiologic="" regression="" stay="" units="" us="" used="" were="" with="" years="" zero-truncated="">

RESULTS:

Weekend admission was significantly correlated with increased LOS and increased average cost (P < .002). This finding was also true for children with both admission and discharge diagnoses of FTT (P < .001). The number of procedures for children admitted on the weekend was not significantly different compared with children admitted on the weekdays (incident rate ratio [IRR]:1.04 [95% confidence interval (CI): 0.99-1.09]). However, weekend admissions did have more radiologic studies (IRR: 1.13 [95% CI: 1.10-1.16]) and laboratory tests (IRR: 1.39 [95% CI: 1.38-1.40]) performed. If one-half of weekend admissions in 2010 with both admission and discharge diagnoses of FTT were converted to Monday admissions, total savings in health care dollars for 2010 would be $534, 145.

CONCLUSIONS:

Scheduled FTT admissions on weekends increased LOS and health care costs compared with weekday admissions of similar levels of complexity. Reduction in planned weekend admissions for FTT could significantly reduce health care costs.