Hospitals & Weekend Deaths
May 21, 2011 by staff
Hospitals & Weekend Deaths, People admitted to hospital over the weekend are 10 percent more likely to die than those who checked in during the week, according to a newanlysis of nearly 30 million people. Even if 10 percent does not sound like much of a difference, when applied to the entire U.S. population equivalent to an additional tens of thousands of people each year, study author Dr. Rocco Ricciardi, of Tufts University Medical School told Reuters Health. “In other words, an extra 20 to 25,000 people die each year in the United States by the admission in a weekend,” he said.
This is not the first study to find a “weekend effect” in which patients are likely to fare worse over the weekend. Previous research has shown a “weekend effect” for patients admitted to the hospital for a heart attack, a blood clot in a lung, a ruptured abdominal artery and bruises of all kinds.
However, data are not always consistent: at the beginning of this year, a survey of hospitals in Pennsylvania found that people with injuries fare slightly better on weekends.
The current study is based on ananlysis of a national sample of nearly 30 million people admitted to hospitals in 35 states over a period of 5 years. All were admitted for “non-elective” reasons, which represents the majority of admissions, said Ricciardi.
Reporting in the journal Archives of Surgery, he and his colleagues found that 2.7 percent of persons admitted during the weekend died in hospital, which came to only 2.3 percent of those admitted on a weekday.
It is not entirely clear why people might fare worse when they come into the weekend, Ricciardi said in e-mail. Looking specifically at the trauma he and his colleagues found no differences in mortality rates between the newcomer’s weekend and weekdays, which helps eliminate the possibility that people experience more deaths on weekends.
But it is possible that the focus is different on weekends, he said – maybe there are fewer nurses, fewer doctors are well trained, or less access to images and other tools.
“O (1) patients attending the hospital on weekends are sicker or more (2), the hospital is doing a worse job of treating them,” said Dr. Raman Khanna at the University of California, San Francisco, did not participate in the study.
Because the researchers found no differences in injury rates, and also took into account whether arrivers weekend had other diseases that could cause more patients, the authors can make the case that the number 2 is more probable, “he told Reuters Health in an email.
Ricciardi and his team also examined the death rates by day of admission to the different diagnoses, and saw that not all worse on the weekends. This is likely because some categories – such as trauma – are concrete steps that are followed in each case, Ricciardi said. “So the services are the same whether it is night, day or weekend or midweek.”
The categories that the worst of weekend rates including problems with pregnancy and the female reproductive system, blood cell and bone marrow disorders and problems of the circulatory and nervous systems.
The results suggest that hospitals should focus their efforts on those specific conditions, Khanna said, “instead of a general increase nursing ratios for all hospitals in all weekend, and that a solution can be adapted equally effective, while much less expensive. “
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