Association of operative day of the week with the length of stay and total hospitalization costs in patients with partial mastectomy : a nationwide database study in Japan

• 資料種別: 記事
• タイトル: Association of operative day of the week with the length of stay and total hospitalization costs in patients with partial mastectomy : a nationwide database study in Japan
• 著者・編者: Takaaki Konishi; Michimasa Fujiogi; Nobuaki Michihata; Kojiro Morita; Hiroki Matsui; Kiyohide Fushimi; Masahiko Tanabe; Yasuyuki Seto; Hideo Yasunaga
• 出版事項: 日本 : Japan Medical Association
• 出版年月日等: 2022-07-15
• 出版年（W3CDTF）: 2022-07-15
• タイトル（掲載誌）: JMA Journal
• 巻号年月日等（掲載誌）: 5(3)
• 掲載巻: 5(3)
• ISSN（掲載誌）: 2433-3298
• ISSN-L（掲載誌）: 2433-328X
• 本文の言語コード: eng
• DOI: 10.31662/jmaj.2022-0007; https://doi.org/10.31662/jmaj.2022-0007
• 国立国会図書館永続的識別子: info:ndljp/pid/14494929; https://dl.ndl.go.jp/pid/14494929
• コレクション（共通）: 障害者向け資料
• コレクション（障害者向け資料：レベル1）: テキストデータ
• コレクション（個別）: 国立国会図書館デジタルコレクション > 電子書籍・電子雑誌 > その他; https://dl.ndl.go.jp/collections/B00035
• 収集根拠: インターネット資料収集保存事業（WARP）
• 受理日（W3CDTF）: 2025-10-21T09:04:40+09:00
• 保存日（W3CDTF）: 2024-09-26
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: インターネット公開
• 遠隔複写可否（NDL）: 不可
• 掲載誌（URI）: https://warp.da.ndl.go.jp/info:ndljp/pid/13747952/www.jmaj.jp/detail.php?id=10.31662%2Fjmaj.2022-0007
• 掲載誌（国立国会図書館永続的識別子）: info:ndljp/pid/14494924; https://dl.ndl.go.jp/pid/14494924
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

• 要約等: <p><b>Introduction</b>: Length of stay (LOS) is a major concern while optimizing medical resources and costs. Hence, factors influencing LOS should be investigated. In Japan, breast cancer surgery generally involves several days of hospitalization for observation, despite few complications. We hypothesized that the day of surgery (weekday; Monday-Friday) affects LOS.</p><p><b>Methods</b>: Using a Japanese nationwide database, we retrospectively identified 146,610 patients who underwent partial mastectomy for stage 0-III breast cancer from July 2010 to March 2017. We conducted multivariable linear and logistic regression analyses adjusting for background characteristics (such as comorbidities and hospital characteristics) with a generalized estimating equation for within-hospital clustering to compare postoperative and total LOS, total hospitalization costs, and postoperative complications between the groups for whom the surgery was performed on different days of the week.</p><p><b>Results</b>: In total, whereas the median postoperative LOS was 4 days (interquartile range, 3-6 days), the median total LOS was 6 days (5-8 days). The median total hospitalization cost was 6,189 US dollars (5,609-6,668 US dollars), and postoperative complications occurred in 3.3% of cases. Despite no significant difference in postoperative complications, Monday-Wednesday surgeries showed significantly shorter postoperative LOS than Friday surgeries (−0.11 days [95% confidence interval, −0.14 to −0.07] on Monday with reference to Friday). Nevertheless, Monday surgeries showed significantly increased total LOS (0.69 days [0.64-0.74]) and hospitalization costs (93 US dollars [71-116]) in comparison with Friday surgeries.</p><p><b>Conclusions</b>: The operative day of the week was associated with increased LOS and cost, with no difference in postoperative complications after partial mastectomy. Surgeries on Monday involved longer preoperative hospital stays and higher total hospitalization costs than those on other weekdays.</p>
• DOI: 10.31662/jmaj.2022-0007
• オンライン閲覧公開範囲: インターネット公開
• 連携機関・データベース: 科学技術振興機構 : J-STAGE; http://www.jstage.jst.go.jp

• 要約等: <p><b>Introduction</b>: Length of stay (LOS) is a major concern while optimizing medical resources and costs. Hence, factors influencing LOS should be investigated. In Japan, breast cancer surgery generally involves several days of hospitalization for observation, despite few complications. We hypothesized that the day of surgery (weekday; Monday-Friday) affects LOS.</p><p><b>Methods</b>: Using a Japanese nationwide database, we retrospectively identified 146,610 patients who underwent partial mastectomy for stage 0-III breast cancer from July 2010 to March 2017. We conducted multivariable linear and logistic regression analyses adjusting for background characteristics (such as comorbidities and hospital characteristics) with a generalized estimating equation for within-hospital clustering to compare postoperative and total LOS, total hospitalization costs, and postoperative complications between the groups for whom the surgery was performed on different days of the week.</p><p><b>Results</b>: In total, whereas the median postoperative LOS was 4 days (interquartile range, 3-6 days), the median total LOS was 6 days (5-8 days). The median total hospitalization cost was 6,189 US dollars (5,609-6,668 US dollars), and postoperative complications occurred in 3.3% of cases. Despite no significant difference in postoperative complications, Monday-Wednesday surgeries showed significantly shorter postoperative LOS than Friday surgeries (−0.11 days [95% confidence interval, −0.14 to −0.07] on Monday with reference to Friday). Nevertheless, Monday surgeries showed significantly increased total LOS (0.69 days [0.64-0.74]) and hospitalization costs (93 US dollars [71-116]) in comparison with Friday surgeries.</p><p><b>Conclusions</b>: The operative day of the week was associated with increased LOS and cost, with no difference in postoperative complications after partial mastectomy. Surgeries on Monday involved longer preoperative hospital stays and higher total hospitalization costs than those on other weekdays.</p>
• DOI: 10.31662/jmaj.2022-0007; https://doi.org/10.31662/jmaj.2022-0007
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（URI）: http://id.ndl.go.jp/digimeta/14494929; https://dl.ndl.go.jp/pid/14494929; https://www.jmaj.jp/download.php?id=10.31662/jmaj.2022-0007; https://search.jamas.or.jp/link/ui/2023252604
• 連携機関・データベース: 国立情報学研究所 : CiNii Research; https://cir.nii.ac.jp/
• 提供元機関・データベース: Japan Link Center; https://japanlinkcenter.org/top; 雑誌記事索引データベース; https://ndlsearch.ndl.go.jp; Crossref; https://www.crossref.org
• 書誌ID（NDLBibID）: 14494929; http://id.ndl.go.jp/bib/14494929