The association of discharge before noon and length of stay in hospitalized pediatric patients

Abstract

BACKGROUND AND OBJECTIVES: To optimize patient throughput, many hospitals set targets for discharging patients before noon (DCBN). However, it is not clear whether DCBN is an appropriate measure for an efficient discharge. This study aims to determine whether DCBN is associated with shorter length of stay (LOS) in pediatric patients and whether that relationship is different between surgical and medical discharges. METHODS: From May 2014 to April 2017, we performed a retrospective data analysis of pediatric medical and surgical discharges belonging to a single academic medical center. Patients were included if they were 21 years or younger with at least one night in the hospital. Propensity score weighted multivariate ordinary least squares models were used to evaluate the association between DCBN and LOS. RESULTS: Of the 8,226 pediatric hospitalizations, 1,531 (18.61%) patients were DCBN. In our multivariate model of all the discharges, DCBN was associated with an average of 0.27 day (P = .014) shorter LOS when compared to discharge in the afternoon. In our multivariate medical discharge model, DCBN was associated with an average of 0.30 (P = .017) day decrease in LOS while the association between DCBN and LOS was not significant among surgical discharges. CONCLUSIONS: On average, at a single academic medical center, DCBN was associated with a decreased LOS for medical but not surgical pediatric discharges. DCBN may not be an appropriate measure of discharge efficiency for all services.