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Influence of Admission Time on Health Care Quality and Utilization in Patients with Stroke: Analysis for a Possible July Effect and Weekend Effect

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  • Chun-Yi Liu

    (Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan
    Department of Education, China Medical University Hospital, Taichung 404332, Taiwan)

  • Pei-Tseng Kung

    (Department of Healthcare Administration, Asia University, Taichung 413305, Taiwan
    Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 404332, Taiwan)

  • Hui-Yun Chang

    (Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan)

  • Yueh-Han Hsu

    (Division of Nephrology, Department of Internal Medicine, Ditmansion Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 600566, Taiwan
    Department of Medical Research, Ditmansion Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 600566, Taiwan
    Department of Nursing, Min-Hwei College of Health Care Management, Tainan 736302, Taiwan)

  • Wen-Chen Tsai

    (Department of Health Services Administration, China Medical University, Taichung 406040, Taiwan)

Abstract

(1) Purpose: Undesirable health care outcomes could conceivably increase as a result of the entry of new, less experienced health care personnel into patient care during the month of July (the July effect) or as a result of the less balanced allocation of health care resources on weekends (the weekend effect). Whether these two effects were present in Taiwan’s National Health Insurance (NHI) system was investigated. (2) Methods: The current study data were acquired from the NHI Research Database. The research sample comprised ≥18-year-old patients diagnosed as having a stroke for the first time from 1 January 2006 to 30 September 2012. The mortality rate within 30 days after hospitalization and readmission rate within 14 days after hospital discharge were used as health care quality indicators, whereas health care utilization indicators were the total length and cost of initial hospitalization. (3) Results: The results revealed no sample-wide July effect with regard to the four indicators among patients with stroke. However, an unexpected July effect was present among in-patients in regional and public hospitals, in which the total lengths and costs of initial hospitalization for non-July admissions were higher than those for July admissions. Furthermore, the total hospitalization length for weekend admissions was 1.06–1.07 times higher than that for non-weekend admissions; the total hospitalization length for weekend admissions was also higher than that for weekday admissions during non-July months. Thus, weekend admission did not affect the health care quality of patients with stroke but extended their total hospitalization length. (4) Conclusions: Consistent with the NHI’s general effectiveness in ensuring fair, universally accessible, and high-quality health care services in Taiwan, the health care quality of patients examined in this study did not vary significantly overall between July and non-July months. However, a longer hospitalization length was observed for weekend admissions, possibly due to limitations in personnel and resource allocations during weekends. These results highlight the health care efficiency of hospitals during weekends as an area for further improvement.

Suggested Citation

  • Chun-Yi Liu & Pei-Tseng Kung & Hui-Yun Chang & Yueh-Han Hsu & Wen-Chen Tsai, 2021. "Influence of Admission Time on Health Care Quality and Utilization in Patients with Stroke: Analysis for a Possible July Effect and Weekend Effect," IJERPH, MDPI, vol. 18(23), pages 1-18, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12362-:d:686900
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    References listed on IDEAS

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    1. Yang, Chiang-Hsing & Huang, Yu-Tung & Janes, Craig & Lin, Kuan-Chia & Lu, Tsung-Hsueh, 2008. "Belief in ghost month can help prevent drowning deaths: A natural experiment on the effects of cultural beliefs on risky behaviours," Social Science & Medicine, Elsevier, vol. 66(9), pages 1990-1998, May.
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