Hospital admissions have significantly worse outcomes during the weekend compared with weekdays, reports a study in the Archives of Surgery.
To uncover whether the mortality rate after nonelective hospital admission is higher during weekends than weekdays, researchers conducted a retrospective cohort analysis of patients.
The study team looked at all patients with a nonelective hospital admission from Jan. 1, 2003, through Dec. 31, 2007, from the admitted to hospitals in the Nationwide Inpatient Sample, a 20% sample of U.S. community hospitals. Researchers abstracted vital status at discharge and calculated the Charlson comorbidity index for all patients. They then adjusted for demographics, comorbidity, and hospital characteristics and compared mortality rates of weekends and weekdays.
Among the nearly 30 million patients with nonelective hospital admissions during the 5-year study period, 6.8 million were admitted on weekends and more than 21 million were admitted on weekdays. Inpatient mortality was reported in 185,856 patients (2.7%) admitted for nonelective indications during weekends and 540,639 (2.3%) during weekdays (P<.001).
There was significantly higher mortality during weekends for 15 of 26 (57.7%) major diagnostic categories. Mortality was 10.5% higher during weekends (odds ratio, 1.10; 95% confidence interval, 1.10-1.11) compared with weekdays after adjusting for all other variables.
Researchers couldn't explain the cause but speculated that differences in hospital staffing and services offered during the weekend compared with weekdays played a part.
Hmmmm. If there's a weekend effect, and that weekend happens during the July effect, then what happens?