• Alvin Rajkomar, Victoria Valencia, Maria Novelero, Michelle Mourad, and Andrew Auerbach.
• Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, San Francisco, California.
• J Hosp Med. 2016 Dec 1; 11 (12): 859-861.

BackgroundDischarging patients before noon is a key approach to improving bed utilization. Few data exist to describe whether patients are discharged earlier or their stay is extended to allow for an early discharge the next day.ObjectiveTo determine if a discharge before noon (DCBN) is associated with length of stay (LOS).Design/Settings/PatientsRetrospective analysis of data from adult medical and surgical discharges from a single academic center from July 2012 through April 2015. We used a multivariable generalized linear model to evaluate the association between DCBN and LOS.ResultsOf 38,365 hospitalizations, 6484 (16.9%) were discharged before noon, and the median LOS was 3.7 days. After adjustment, DCBN was associated with a longer LOS (adjusted odds ratio [OR]: 1.043, 95% confidence interval [CI]: 1.003-1.086). The association between longer LOS and DCBN was more pronounced in patients admitted emergently (n = 14,192, 37%) (adjusted OR: 1.14, 95% CI: 1.033-1.249).ConclusionsAlthough we cannot discern whether discharges were delayed to achieve discharge before noon, earlier discharge was associated with a longer LOS, particularly among emergent admissions. Journal of Hospital Medicine 2015;11:859-861. © 2015 Society of Hospital Medicine.© 2015 Society of Hospital Medicine.

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