BACKGROUND Financial pressures for reducing hospitalization costs have driven to a move toward same day discharge (SDD) following uncomplicated percutaneous coronary intervention. The UK healthcare system has transitioned to predominantly SDD for elective percutaneous coronary intervention. This study aimed to examine patient's clinical, procedural, and institutional characteristics that are associated with the increased adoption of SDD adoption over time in the United Kingdom and determine whether these vary by region. METHODS The data were derived from the British Cardiovascular Intervention Society including all the elective percutaneous coronary intervention from 2007 to 2014 in the United Kingdom. We structured 8 meaningful groups of variables, and their relative importance was obtained by decomposing the R2 in each study year. RESULTS The relative importance of Strategic Health Authorities was substantially higher than all other factors every year, with some reduction over time, from 49.2% (95% CI, 45.4%-52.4%) in 2007 to 43.4% (95% CI, 39.9%-46.6%) in 2014. Center volume followed with 8.95% (95% CI, 7.0%-10.9%) to 19.8% (95% CI, 16.7%-22.4%). Between patients' clinical and procedural characteristics, pharmacology and access site had the highest relative importance values, from 14.3% (95% CI, 12.1%-16.4%) to 7.1% (95% CI, 5.5%-8.8%) and from 3.6% (95% CI, 2.3%-5.1%) to 11.8% (95% CI, 9.4%-14.3%), respectively. Relative importance of different groups varied differently across Strategic Health Authorities. CONCLUSIONS Growth of SDD was mainly associated with regional characteristics, while subcontributors varied substantially between different regions. Standardized guidelines would provide more homogenous adoption of SDD nationally. This analysis might be of wider interest in healthcare systems slower in SDD adoption.

中文翻译：

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选择性经皮冠状动脉介入治疗后当天放电的增长。

背景技术在不复杂的经皮冠状动脉介入治疗之后，用于减少住院费用的财务压力已促使其朝着当天出院（SDD）迈进。英国医疗保健系统已过渡到主要用于选择性经皮冠状动脉介入治疗的SDD。这项研究旨在检查患者的临床，程序和机构特征，这些特征与英国随时间推移采用SDD的采用率增加有关，并确定这些特征是否因地区而异。方法数据来自英国心血管介入学会，包括2007年至2014年英国的所有选择性经皮冠状动脉介入治疗。我们构造了8个有意义的变量组，并且它们的相对重要性是通过在每个研究年度中分解R2来获得的。结果战略卫生部门的相对重要性每年都大大高于所有其他因素，并且随着时间的推移有所降低，从2007年的49.2％（95％CI，45.4％-52.4％）下降到43.4％（95％CI，39.9％） -46.6％）在2014年。中心排名紧随其后的是8.95％（95％CI，7.0％-10.9％）到19.8％（95％CI，16.7％-22.4％）。在患者的临床和程序特征之间，药理学和进入部位的相对重要性最高，从14.3％（95％CI，12.1％-16.4％）到7.1％（95％CI，5.5％-8.8％）和3.6百分比（95％CI，2.3％-5.1％）至11.8％（95％CI，9.4％-14.3％）。在战略卫生部门中，不同群体的相对重要性有所不同。结论SDD的增长主要与区域特征有关，而不同区域之间的子贡献者差异很大。标准化指南将在全国范围内更统一地采用SDD。对于SDD采纳较慢的医疗保健系统，此分析可能会引起广泛关注。