Key result
Discharge before noon was associated with a longer length of stay (adjusted OR 1.043; 95% CI 1.003-1.086), with a more pronounced association in emergent admissions.
Why the study?
Is discharge before noon associated with length of stay in adult medical and surgical patients?
Observational (n=38,365)
No
Is discharge before noon associated with length of stay in adult medical and surgical patients?
Odds Ratio: 1.043 (95% CI 1.003–1.086)
Discharging patients before noon is paradoxically associated with a longer length of stay, particularly among emergent admissions.
Discharge-before-noon policies warrant caution; leaves open causality in this Level 3 cohort.
BACKGROUND: Discharging patients before noon is a key approach to improving bed utilization. Few data exist to describe whether patients are discharged earlier or their stay is extended to allow for an early discharge the next day. OBJECTIVE: To determine if a discharge before noon (DCBN) is associated with length of stay (LOS). DESIGN/SETTINGS/PATIENTS: Retrospective analysis of data from adult medical and surgical discharges from a single academic center from July 2012 through April 2015. We used a multivariable generalized linear model to evaluate the association between DCBN and LOS. RESULTS: Of 38,365 hospitalizations, 6484 (16.9%) were discharged before noon, and the median LOS was 3.7 days. After adjustment, DCBN was associated with a longer LOS (adjusted odds ratio [OR]: 1.043, 95% confidence interval [CI]: 1.003-1.086). The association between longer LOS and DCBN was more pronounced in patients admitted emergently (n = 14,192, 37%) (adjusted OR: 1.14, 95% CI: 1.033-1.249). CONCLUSIONS: Although we cannot discern whether discharges were delayed to achieve discharge before noon, earlier discharge was associated with a longer LOS, particularly among emergent admissions. Journal of Hospital Medicine 2015;11:859-861.
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Rajkomar et al. (2015) conducted an observational in Medical and surgical hospitalizations (n=38,365). Discharge before noon was evaluated on Length of stay (LOS) (OR 1.043, 95% CI 1.003-1.086). Discharge before noon was associated with a longer length of stay (adjusted OR 1.043; 95% CI 1.003-1.086), with a more pronounced association in emergent admissions.
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