Off-Hour Stroke Patients Experience Poorer Quality of Care, Outcomes

Stroke patients admitted to hospitals on nights and weekends received poorer quality care and were more likely to die within 30 days than those admitted during on-hours, according to the results of a Danish study.

The study, published online November 6, 2014, in Stroke, compared compliance with performance measures for acute stroke care process for patients admitted during on-hours and those admitted during off hours on nights and weekends. Patients admitted to Danish hospitals for their first stroke from 2003 to 2011 were included in the analysis.

Patients admitted during off-hours were significantly less likely to receive care that met 8 out of 10 performance measures. This difference in quality diminished over time, however. In addition, patients admitted during off-hours were 15% more likely to die within 30 days. The results indicated, however, that these differences in mortality rates were primarily explained by stroke severity.

“During the study period, 7 am to 3 pm was the only time during the day where the units in general were fully staffed, with the different healthcare professionals required in modern interdisciplinary stroke care,” the study authors wrote. “Outside this time frame, the nurse ratio was typically lower and the access to occupational therapists and physiotherapists restricted.”