SHM Converge Scientific Abstract ePoster Gallery-Characteristics and Outcomes of Hospitalized Patients Discharged Before Noon

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This retrospective cohort study examined 27,933 adult discharges from a large academic hospital in 2023 to assess whether discharge before noon (DBN) is associated with patient outcomes. DBN occurred in 19% of discharges. Patients discharged before noon were slightly younger, more often discharged home, and less likely to have ICU utilization or discharge to post-acute care than those discharged later in the day.<br /><br />Unadjusted outcomes favored the DBN group: 30-day mortality was 2.2% versus 3.0%, and 30-day readmission was 11.3% versus 15.0%. However, after adjustment for age, sex, race and ethnicity, ICU use, zip code, diagnosis, discharge disposition, hospital service, and hospital floor, DBN was not associated with a significant difference in 30-day mortality (odds ratio 0.90, 95% CI 0.72–1.11; p=0.331). DBN remained modestly associated with lower 30-day readmission risk (odds ratio 0.84, 95% CI 0.76–0.92; p=0.001).<br /><br />The study also found that older age, ICU use, and discharge to home health, rehab, or skilled nursing were associated with lower odds of DBN. These findings suggest that patients who discharge early tend to be less complex and more predictable clinically.<br /><br />Overall, the authors conclude that encouraging discharge by noon does not appear to harm patients, at least in terms of mortality. The lower readmission rate seen with DBN is likely due to patient selection rather than a direct protective effect. They recommend that if hospitals use DBN as an operational target, they should focus on disease-specific discharge protocols rather than a broad emphasis on early discharge.

Asset Subtitle

Stephen Biederman

Meta Tag

Author List Alan Dow, Francesca Capanni Orams, Matthew Ambrosio, Rehan Qayyum, Stephen Biederman

Category Research

Concept Study Design

Concept Discharge Before Noon

Concept Hospitalized Adults

Concept 30-Day Outcome

Concept Mortality

Distinguished Non-Finalist

Presenter Organization VCU Health System

Presenting Author Stephen Biederman

Track Transitions of Care

Keywords

discharge before noon

retrospective cohort study

hospital discharge

30-day mortality

30-day readmission

patient outcomes

adjusted odds ratio

ICU utilization

post-acute care

discharge protocols

Study Design

Discharge Before Noon

Hospitalized Adults

30-Day Outcome

Mortality