Original articleMortality among adult patients admitted to the hospital on weekends
Introduction
Staffing levels tend to be lower on weekends than on weekdays. The reduction in the number of clinical workers on weekends may lead to shortfalls in care. Earlier studies suggested that weekend admission was associated with increased resource utilization and slightly higher mortality than weekday admission [1], [2], [3], [4]. Only recently, however, have researchers begun to examine the effects of weekend admissions on in-hospital mortality among diverse patient groups. These studies demonstrated that the overall adjusted hospital mortality rate of patients admitted to the intensive care unit (ICU) on weekends and of infants born on weekends was no higher than that of patients admitted or born on weekdays [5], [6]. This could be explained by the fact that resources and commitment to ICUs and neonatal units do not differ during the week. It was hypothesized that if necessary staffing, diagnostic studies and therapeutic procedures were available at all times, the outcomes would not change during the week.
We conducted a study involving all acute admissions to a tertiary acute care hospital in Spain over a 5-year period in order to compare the rate of death among patients admitted to the hospital on weekends with the rate among patients admitted on weekdays.
Section snippets
Methods
We identified every patient admitted to our hospital, Fundación Hospital Alcorcón, Madrid, Spain, via the emergency department between January 1, 1999 and December 31, 2003. We excluded all elective admissions, elective transfers, critical care patients and births. Hospital discharge data were obtained from de CMBD (hospital database). The data set contains detailed administrative and clinical data regarding all admissions during this period. Trained abstractors working on site collected
Results
During the 5-year study period, there were 35,993 hospital admissions, or about 19.7 per day. The median age of the patients was 52.59 (S.D. 31.21) years, 19.8% were children younger than 14 years and 48.7% were women. The median stay was 6.43 (S.D. 7.7) days. A total of 2156 patients died (6.0%), 674 (1.9%) of them within the first 48 h. Overall, 23.4% (8431) of the patients were admitted on the weekend. There were no large differences in baseline characteristics between patients admitted on
Discussion
We examined more than 35,000 consecutive emergency hospitalizations of adult patients in Fundación Hospital Alcorcón, Madrid, over a 5-year period. The study demonstrated that patients admitted to our hospital via the emergency department on weekends had an increased risk of dying within the first 48 h when compared with patients admitted on weekdays. The increase in mortality persisted after adjusting for age, gender, CCI and DRG weight. However, global mortality was similar in both groups.
References (10)
- et al.
Effects of weekend admission and hospital teaching status on in-hospital mortality
Am J Med
(2004) - et al.
The hospital mortality of patients admitted to the ICU on weekends
Chest
(2004) - et al.
A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
J Chronic Dis
(1987) - et al.
Waiting for urgent procedures on the weekend among emergently hospitalized patients
Am J Med
(2004) Promoting good medical care
Eur J Intern Med
(2004)
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