Patients admitted on weekends at higher death risk: study

Patients admitted to 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 new analysis of government-run hospitals in the UK has found.
The study examined the effect of hospital admission day on death rates across National Health Service (NHS) England hospitals for 2013-2014.
The results confirm findings from an analysis they undertook for 2009-2010, researchers said.
In the latest 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).

This suggests a generalised "weekend effect" which can be partly explained by the reduced support services that start from late Friday through the weekend, leading to disruption on Monday morning, researchers said.
Patients already in hospital over the weekend do not have an increased risk of death. These results remained the same even when taking into account the severity of illness.

The researchers 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."
They said 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."

They also looked at patient characteristics, length of hospital stay, and time to death.
An average of 2.7 million patients were admitted to hospital on each weekday, while an average of 1.2 million patients were admitted on a Saturday and 1 million patients admitted on a Sunday.
Saturday and Sunday admissions were more likely to be emergencies, 50 per cent and 65 per cent respectively, than on weekdays (29 per cent) 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 per cent and 29.2 per cent respectively, compared with less than 20 per cent of weekday admissions.

Researchers cautioned against using the data to estimate avoidable deaths, but call for more research into how services can be improved to reduce risk.
The study was published in the journal BMJ.