The Impact of Weekend Admission and Patient Safety Indicator on 30-Day Mortality among Korean Long-Term Care Insurance Beneficiaries
10.4332/KJHPA.2019.29.2.228
- Author:
Jaeyong SHIN
1
;
Jae Hyun KIM
Author Information
1. Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea.
- Publication Type:Original Article
- Keywords:
Admission;
Ageing;
Mortality;
Safety
- MeSH:
Case-Control Studies;
Diagnosis;
Humans;
Incidence;
Insurance Benefits;
Insurance, Long-Term Care;
Long-Term Care;
Mortality;
National Health Programs;
Odds Ratio;
Patient Safety;
Seasons
- From:Health Policy and Management
2019;29(2):228-236
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: This study investigates the impact of weekend admission with a patient safety indicator (PSI) on 30-day mortality among long-term insurance beneficiaries. METHODS: Data were obtained from the National Health Insurance Service-Senior claim database from 2002 to 2013. To obtain unbiased estimates of odds ratio, we used a nested case-control study design. The cases were individuals who had a 30-day mortality event after their last medical utilization, while controls were selected by incidence density sampling based on age and sex. We examined the interaction between the main independent variables of weekend admission and PSI by categorizing cases into four groups: weekend admission/PSI, weekend admission/non-PSI, weekday admission/PSI, and weekday admission/non-PSI. RESULTS: Of the 83,400 individuals in the database, there were 20,854 cases (25.0%) and 62,546 controls (75.0%). After adjusting for socioeconomic, health status, seasonality, and hospital-level factors, the odds ratios (ORs) of 30-day mortality for weekend admission/PSI (OR, 1.484; 95% confidence interval [CI], 1.371–1.606) and weekday admission/PSI (OR, 1.357; 95% CI, 1.298–1.419) were greater than for patients with weekday admission/non-PSI. CONCLUSION: This study indicated that there is an increased risk of mortality after weekend admission among patients with PSI as compared with patients admitted during the weekday without a PSI. Therefore, our findings suggest that recognizing these different patterns is important to identify at-risk diagnosis to minimize the excess mortality associated with weekend admission in those with PSI.
