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How do busy hospital circumstances affect mortality and readmission within 60 days: A cohort study of 680 000 acute admissions in Norway

OBJECTIVE: To study mortality and readmissions for older patients admitted during more and less busy hospital circumstances. DESIGN: Cohort study where we identified patients that were admitted to the same hospital, during the same month and day of the week. We estimated effects of inflow of acute p...

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Autores principales: Nilsen, Sara Marie, Asheim, Andreas, Carlsen, Fredrik, Sarheim Anthun, Kjartan, Vatten, Lars Johan, Aam, Stina, Davies, Neil M, Bjørngaard, Johan Håkon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614243/
https://www.ncbi.nlm.nih.gov/pubmed/35644720
http://dx.doi.org/10.1016/j.healthpol.2022.05.008
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author Nilsen, Sara Marie
Asheim, Andreas
Carlsen, Fredrik
Sarheim Anthun, Kjartan
Vatten, Lars Johan
Aam, Stina
Davies, Neil M
Bjørngaard, Johan Håkon
author_facet Nilsen, Sara Marie
Asheim, Andreas
Carlsen, Fredrik
Sarheim Anthun, Kjartan
Vatten, Lars Johan
Aam, Stina
Davies, Neil M
Bjørngaard, Johan Håkon
author_sort Nilsen, Sara Marie
collection PubMed
description OBJECTIVE: To study mortality and readmissions for older patients admitted during more and less busy hospital circumstances. DESIGN: Cohort study where we identified patients that were admitted to the same hospital, during the same month and day of the week. We estimated effects of inflow of acute patients and the number of concurrent acute inpatients. Mortality and readmissions were analysed using stratified Cox-regression. SETTING: All people 80 years and older acutely admitted to Norwegian hospitals between 2008 and 2016. MAIN OUTCOME MEASURES: Mortality and readmissions within 60 days from admission. RESULTS: Among 294 653 patients with 685 197 admissions, mean age was 86 years (standard deviation 5). Overall, 13% died within 60 days. An interquartile range difference in inflow of acute patients was associated with a hazard ratio (HR) of 0.99, 95% confidence interval (95% CI) 0.98 to 1.00). There was little evidence of differences in readmissions, but a 7% higher risk (HR 1.07, 95% CI 1.06 to 1.09) of being discharged outside ordinary daytime working hours. CONCLUSIONS: Older patients admitted during busier circumstances had similar mortality and readmissions to those admitted during less busy periods. Yet, they showed a higher risk of discharge outside daytime working hours. Despite limited effects of busyness on a hospital level, there could still be harmful effects of local situations.
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spelling pubmed-76142432023-02-25 How do busy hospital circumstances affect mortality and readmission within 60 days: A cohort study of 680 000 acute admissions in Norway Nilsen, Sara Marie Asheim, Andreas Carlsen, Fredrik Sarheim Anthun, Kjartan Vatten, Lars Johan Aam, Stina Davies, Neil M Bjørngaard, Johan Håkon Health Policy Article OBJECTIVE: To study mortality and readmissions for older patients admitted during more and less busy hospital circumstances. DESIGN: Cohort study where we identified patients that were admitted to the same hospital, during the same month and day of the week. We estimated effects of inflow of acute patients and the number of concurrent acute inpatients. Mortality and readmissions were analysed using stratified Cox-regression. SETTING: All people 80 years and older acutely admitted to Norwegian hospitals between 2008 and 2016. MAIN OUTCOME MEASURES: Mortality and readmissions within 60 days from admission. RESULTS: Among 294 653 patients with 685 197 admissions, mean age was 86 years (standard deviation 5). Overall, 13% died within 60 days. An interquartile range difference in inflow of acute patients was associated with a hazard ratio (HR) of 0.99, 95% confidence interval (95% CI) 0.98 to 1.00). There was little evidence of differences in readmissions, but a 7% higher risk (HR 1.07, 95% CI 1.06 to 1.09) of being discharged outside ordinary daytime working hours. CONCLUSIONS: Older patients admitted during busier circumstances had similar mortality and readmissions to those admitted during less busy periods. Yet, they showed a higher risk of discharge outside daytime working hours. Despite limited effects of busyness on a hospital level, there could still be harmful effects of local situations. 2022-08-01 2022-05-21 /pmc/articles/PMC7614243/ /pubmed/35644720 http://dx.doi.org/10.1016/j.healthpol.2022.05.008 Text en https://creativecommons.org/licenses/by/4.0/This work is licensed under a CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/) International license.
spellingShingle Article
Nilsen, Sara Marie
Asheim, Andreas
Carlsen, Fredrik
Sarheim Anthun, Kjartan
Vatten, Lars Johan
Aam, Stina
Davies, Neil M
Bjørngaard, Johan Håkon
How do busy hospital circumstances affect mortality and readmission within 60 days: A cohort study of 680 000 acute admissions in Norway
title How do busy hospital circumstances affect mortality and readmission within 60 days: A cohort study of 680 000 acute admissions in Norway
title_full How do busy hospital circumstances affect mortality and readmission within 60 days: A cohort study of 680 000 acute admissions in Norway
title_fullStr How do busy hospital circumstances affect mortality and readmission within 60 days: A cohort study of 680 000 acute admissions in Norway
title_full_unstemmed How do busy hospital circumstances affect mortality and readmission within 60 days: A cohort study of 680 000 acute admissions in Norway
title_short How do busy hospital circumstances affect mortality and readmission within 60 days: A cohort study of 680 000 acute admissions in Norway
title_sort how do busy hospital circumstances affect mortality and readmission within 60 days: a cohort study of 680 000 acute admissions in norway
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614243/
https://www.ncbi.nlm.nih.gov/pubmed/35644720
http://dx.doi.org/10.1016/j.healthpol.2022.05.008
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