Prevalence, trends, and outcomes of same-day discharge following elective percutaneous coronary intervention: a retrospective observational cohort study using routinely collected health data.

Abstract

Aims: To identify the prevalence, trends, and outcomes of same-day discharge (SDD) following elective percutaneous coronary intervention (PCI) among six public hospitals in Queensland, Australia.

Methods and results: A retrospective observational research design was used. A total of 4387 cases were obtained from the Queensland Cardiac Outcomes Registry and National Hospital Cost Data Collection. The two data sets were linked using identifiable data items. Patients were those who had elective PCI between December 2012 and December 2019 either discharged the same day of the procedure or the next day. Data were analysed using descriptive and inferential statistics. The overall SDD prevalence was 6.5%, with a trend increasing from 0.2% in 2013 to 9.0% in 2019. The prevalence varied at the individual hospital level. Two hospitals did not perform SDD during the study period. The remaining hospitals demonstrated variability in SDD prevalence, with the highest from one hospital being 28.2% in 2019. Almost all SDD patients experienced no complications during or following PCI within 24 h. Compared with next-day discharge, SDD reduced the length of stay by 18 h and conferred an average of $3695 cost-savings per patient.

Conclusion: There was limited implementation of SDD in the six public hospitals contributing data to this study. Improvement in the SDD rate could result in better hospital resource utilization and reduce low-value care. Hence, strategies to implement and promote SDD are warranted.