Patients admitted as emergencies at the weekend are significantly older and more dependent than those admitted to hospital on other days of the week, suggests a study at a major acute trust.
While staffing levels may have a part to play, the profile of patients may help explain the seemingly higher mortality among medical emergencies at weekends, said the researchers in Emergency Medicine Journal.
”These findings illustrate major differences in the age and functional dependence of patients admitted to hospital at weekends”
They based their findings on an analysis of 536 patients admitted to the acute medical unit of a large teaching hospital in Northern Ireland during November 2012.
They compared the profile of patients admitted as medical emergencies between 5pm hours on Friday and 9am hours on Monday with those admitted on other days of the week.
As there were proportionally more night shifts worked during weekends than on week days, the researchers also compared the profile of patients arriving in the unit during both the day and night at weekends and on week days.
Their analysis found no major differences in the severity of illness between patients admitted on weekdays and weekends, as evidenced by key clinical indicators and test results.
However, patients admitted at the weekend as medical emergencies were significantly older – on average, more than 3.5 years – than those admitted at other times of the week.
They were also more physically incapacitated than patients admitted during the week, as measured by the Rankin disability scale – attracting an average score of three compared with two for weekday admissions.
Patients admitted during the day at weekends were also more functionally dependent than those admitted during the day on other days of the week.
They said: “These findings illustrate major differences in the age and functional dependence of patients admitted to hospital at weekends. This [difference in profile] may fully or partially explain the increased mortality that has been publicised.”
They suggested the findings had implications for the current debate on the seniority and number of staff on duty during out of hours periods, sparked by the government’s ambitions for a truly seven-day NHS.
However the authors acknowledged that their study only reflected the experience of the Royal Victoria Hospital in Belfast, so may not be indicative of patterns elsewhere.