Postdischarge outcomes in heart failure are better for teaching hospitals and weekday discharges.

نویسندگان

  • Finlay A McAlister
  • Anita G Au
  • Sumit R Majumdar
  • Erik Youngson
  • Raj S Padwal
چکیده

BACKGROUND It is unclear whether teaching status or day of discharge influences outcomes after a heart failure hospitalization. METHODS AND RESULTS We evaluated adults discharged after a heart failure hospitalization between 1999 and 2009 in Alberta, Canada. The primary outcome was death or nonelective readmission 30 days postdischarge. Of 12 216 patients discharged from teaching hospitals and 12 157 patients from nonteaching hospitals, 20 524 (84%) discharges occurred on weekdays. Although they had greater comorbidity and used more healthcare resources before their heart failure hospitalization, patients discharged from teaching hospitals exhibited shorter lengths of stay (adjusted ratio, 0.83; 95% confidence interval [CI], 0.80-0.86) and significantly lower rates of death or readmission in the 30 days after discharge than those discharged from nonteaching hospitals (17.4% versus 22.1%; adjusted hazard ratio [aHR], 0.83; 95% CI, 0.77-0.89). Patients discharged on weekdays were older and had greater comorbidity, yet exhibited significantly lower rates of death or readmission at 30 days than those discharged on weekends (19.5% versus 21.1%; aHR, 0.87; 95% CI, 0.80-0.94). Compared with weekend discharge from a nonteaching hospital, 30-day death/readmission rates were lower for weekday discharge from a nonteaching hospital (aHR, 0.85; 95% CI, 0.77-0.94), weekend discharge from a teaching hospital (aHR, 0.80; 95% CI, 0.69-0.92), and weekday discharge from a teaching hospital (aHR, 0.71, 95% CI, 0.63-0.79). CONCLUSIONS Patients discharged from teaching hospitals or on weekdays exhibited better outcomes despite having higher risk profiles. Future studies should focus on distinguishing which discharge processes differ between teaching and nonteaching hospitals and between weekdays and weekends to define those that optimize patient outcomes.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

In reference to "Similar outcomes among general medicine patients discharged on weekends".

BACKGROUND Hospitals reduce staffing levels and services on weekends. This raises the question of whether weekend discharges may be inadequately prepared and thus at higher risk for adverse events postdischarge. OBJECTIVE To compare death or nonelective readmission rates 30 days after weekend versus weekday discharge. DESIGN Retrospective cohort. SETTING All teaching hospitals in Alberta,...

متن کامل

Day of admission and clinical outcomes for patients hospitalized for heart failure: findings from the Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure (OPTIMIZE-HF).

BACKGROUND Differences in hospital staffing may influence outcomes for patients with acute conditions, including heart failure (HF), depending on which day of the week the patients are admitted. This study examined the relationship between the day of the week patients are hospitalized for HF and death rate, length of stay (LOS), and rehospitalization rate. METHODS AND RESULTS A total of 259 U...

متن کامل

The effect of cardiovascular credentialed pharmacists on process measures and outcomes in myocardial infarction and heart failure.

OBJECTIVE The purpose of this study was to determine if institutions with inpatient cardiovascular credentialed pharmacists exhibit improved quality measures for acute myocardial infarction (AMI) and heart failure (HF) care compared with institutions without inpatient cardiovascular credentialed pharmacists. METHODS We conducted a multicenter, retrospective, cross-sectional, matched case-cont...

متن کامل

THE EFFECT OF SLEEP HYGIENE EDUCATION ON SLEEP QUALITY OF PATIENTS WITH HEART FAILURE HOSPITALIZED IN CARDIAC CARE UNITS OF URMIA TEACHING HOSPITALS 2017-2018

Background & Aim: Heart failure is considered one of the most common chronic illnesses in the whole world and is associated with many symptoms due to heart failure in the bloodstream. This study was a clinical trial with the aim of determining the effect of sleep health education on the quality of sleep in patients with heart failure hospitalized in cardiac care units of Orumiyeh educational ce...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Circulation. Heart failure

دوره 6 5  شماره 

صفحات  -

تاریخ انتشار 2013