Medical Research: What is the background for this study? What are the main findings?
Dr. Sorita: Prior studies have suggested that patients with heart attack who are admitted during off-hours (weekends, nights and holidays) have higher risk of death when compared with patients admitted during regular hours. In our study, we found that patients undergoing percutaneous coronary interventions for heart attack who were admitted during off-hours did not have higher mortality or readmission rates as compared with ones admitted during regular hours at a highly-integrated academic center in the United States.
Medical Research: What should clinicians and patients take away from your report?
Dr. Sorita: At our institution, patients who undergo percutaneous coronary interventions are treated with comparative care processes and protocols. This may explain why there was no difference in outcomes for patients admitted during off-hours vs. regular hours. Future efforts to improve systems of care should be directed to achieve comparable patient outcomes regardless of time of presentation to a health care facility.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Sorita: Our study raises the question whether consistent care processes and resource availability at hospitals are key for achieving comparable outcomes for patients with heart attack between off-hours and regular hours. We recommend future studies explore the variation in the quality of care by time of day such as number of staff, expertise of staff, and other structural and process attributes in systems of care and their association with clinical outcomes.