589 - Is there a weekend effect for pediatric respiratory hospitalizations?

Publication Number: 2574.589

Gregory Ison, JSUMC K Hovnanian Children's Hospital, Parlin, NJ, United States; Srividya Naganathan, JSUMC, Neptune, NJ, United States; Daniel A. Rauch, Hackensack Meridian School of Medicine, Hackensack, NJ, United States; John Stephens, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States; Yevgeniya Harrington, Boston Children's Hospital, Boston, MA, United States; Yen-Hong Kuo, Hackensack Meridian School of Medicine, Neptune, NJ, United States; Matt hall, Children's Hospital Association, Lenexa, KS, United States; Jamie M. Pinto, K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, Neptune, NJ, United States

Background: The "weekend effect" is the concept that length of stay (LOS), morbidity, and mortality are increased for those admitted on the weekend compared to a weekday. This is described in adult studies with inconsistent findings in pediatric literature. Respiratory complaints are frequent causes for admission of pediatric patients.This study's aim is to assess whether the "weekend effect" occurs with pediatric respiratory hospitalizations.

Objective: To assess if there was an association between admission timing (weekend vs. weekday) with LOS or mortality for common pediatric respiratory conditions.

Design/Methods: This was a retrospective database study of the Kids' Inpatient Database (KID) 2022 for the 5 most common respiratory diagnoses: Bronchiolitis & RSV Pneumonia, Respiratory Failure, Asthma, Other Pneumonia, and Major respiratory infections & inflammations. Our main outcomes were LOS (in days) and mortality. Hospital location and teaching status was also analyzed. The KID weights were used to generate national estimates of hospital admissions. The demographic characteristics and outcomes of hospitalized children and hospital characteristics were compared by using Rao-Scott chi-square tests for categorical variables and t-tests for continuous variables.

Results: There were 229,222 hospitalizations included. Table 1 shows demographic data by diagnosis. For all 5 diagnoses, there was no difference in patient demographics (age, sex) or outcomes (LOS, mortality) for weekday vs. weekend admissions (Table 1). Additionally, mortality was extremely low ( < 1%) for all diagnoses. There was a statistical, but not clinically relevant difference in frequency of weekday vs. weekend admissions by hospital location and teaching status for 2 of the diagnoses, bronchiolitis & RSV pneumonia and major respiratory infections & inflammations (Table 1).

Conclusion(s): In a nationally representative sample of pediatric hospitalizations, there is no evidence for the "weekend effect" among the 5 most frequent pediatric respiratory diagnoses. Multi-center, prospective studies are needed to confirm no "weekend effect" for pediatric respiratory hospitalizations.

Table 1
Patient Characteristics and Outcomes by Condition for Weekday vs. Weekend Admissions