Hospital death rates support the 'weekend effect' phenomenon

Patients in several developed countries who are admitted to hospitals on Saturdays and Sundays are more likely to die within 30 days than patients with similar conditions who are hospitalized during the week,  according to a new study published in BMJ Quality & Safety.

The weekend effect phenomenon is well-known in the United States but also occurs in other countries, researchers found. 

This study used data from the Global Comparators Project to examine nearly three million admissions during the weekend between 2009 and 2012 from 28 hospitals in England, the United States, Australia and The Netherlands, focusing on deaths that occurred within 30 days of emergency admission or planned surgery. The chance of death was 8 percent higher in 11 hospitals in England, 13 percent greater in five hospitals in the United States and 20 percent more likely in six Dutch hospitals. In Australia, the link between emergency admissions and weekends was apparent within seven days but not weeks later.

But the reason why the phenomen occurs is unclear, researchers said. "We were unable to look at staffing or access to services within the hospital," study coauthor Paul Aylin, a professor of epidemiology and public health in the School of Public Health at Imperial College London, said, Today Health reported

"Our own work around stroke care in the UK suggests that patients admitted at the weekends are less likely to get a same-day brain scan, less likely to get clot-busting treatment and have worse outcomes across a range of indicators," he said.

But the international scope of the problem shows that further study is necessary to determine the reasons for the weekend effect. "Understanding the weekend effect is an extremely important task since it is large, at about 10 percent in relative risk terms and 0.4 percent in percentage point terms. This amounts to about 160 additional deaths in a hospital with 40,000 discharges per year," said Professor Richard Lilford of the University's Warwick Medical School, in an accompanying opinion piece in BMJ.

In order to address this well-documented phenomenon, Lilford and coauthor Yen-Fu Chen outlined strategies for further analysis such as, direct examination of quality of care during weekdays and over weekends, and disease-specific studies.

To learn more:
- read the study findings
- here is the opinion piece
- read the Today Health report

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