Weekend hospital admissions linked to higher death risk

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London, Sep 6 (IANS) Patients admitted to a hospital at the weekend are more likely to be sicker and have a higher risk of death compared with those admitted during the week, a study has found.

In the analysis, the authors found that around 11,000 more people die each year within 30 days of admission to hospital on Friday, Saturday, Sunday, or Monday compared with other days of the week (Tuesday, Wednesday, Thursday) in Britain.

The analysis was carried out as a collaboration between University Hospital Birmingham NHS Foundation Trusts and University College London.

The team examined the effect of hospital admission day on death rates across NHS England hospitals for 2013-2014.

This suggests a generalised “weekend effect” which can be partly explained by the reduced support services that starts from late Friday through the weekend, leading to disruption on Monday morning, the authors said.

An average of 2.7 million patients were admitted to a hospital on each weekday, while an average of 1.2 million patients were admitted on a Saturday and one million patients admitted on a Sunday.

Saturday and Sunday admissions were more likely to be emergencies, 50 percent and 65 percent, respectively, than on weekdays (29 percent) and length of stay was also higher for patients admitted on a Saturday and Sunday.

A higher proportion of patients admitted on a Saturday and Sunday had diagnoses that placed them in the highest risk of death category, 24.6 percent and 29.2 percent, respectively, compared with less than 20 percent of weekday admissions.

These results remained the same even when taking into account the severity of illness.

The authors caution that it is not possible to show that this excess number of deaths could have been prevented, adding that to do so would be “rash and misleading”.

Nevertheless, they say the number is “not otherwise ignorable” and “we need to determine exactly which services need to be improved at the weekend to tackle the increased risk of mortality”.

The debate on seven-day working was reignited following health secretary Jeremy Hunt’s recent call for hospital doctors to work at weekends to improve quality of care and reduce deaths.

In an accompanying feature article, Helen Crump at the Nuffield Trust said it is not clear how or to what extent investment in seven day services will reduce weekend deaths and that the costs may outweigh any benefits.

She also warned that ramping up services at the weekend “will leave a gap in the hospital’s weekday rota, with potentially serious consequences across other services”.

The new results, published in the journal BMJ, confirm findings from an analysis the same team undertook for 2009-2010.

Patients already in hospital over the weekend do not have an increased risk of death, the authors said.

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