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Hospital weekend death rate ‘not just NHS problem’

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Heightened mortality rates for weekend admissions are not just a problem for hospitals in England and are also evident in Australia, US and the Netherlands.

The so-called “weekend effect” is a feature of several developed countries’ healthcare systems, reveals research, suggesting it is a systematic phenomenon.

“The international nature of our database suggests that this is a systematic phenomenon affecting healthcare providers across borders”

Study authors

The findings come as the government is seeking to turn the NHS into what it has termed a “truly seven-day service”, with more services available at weekends and in the evening.

The new study looked at the Global Comparators project – an international database to which more than 50 hospitals in the UK, US, Australia, the Netherlands, Italy, Spain, Belgium, Finland, Norway and Denmark contribute.

The researhcers looked at data on almost three million admissions at 28 teaching hospitals in England, Australia, the US and the Netherlands.

They focused on deaths occurring in hospital within 30 days of an emergency admission or elective surgery.

They found that, after taking account of influential factors, the risk of dying within 30 days was higher for emergency admissions at weekends in three out of the four countries.

This risk was 8% higher in 11 hospitals in England, 13% higher in five of the US hospitals, and 20% higher in six Dutch hospitals.

There was no significant daily variation in mortality risk within 30 days for emergency weekend admissions in the Australian hospitals, but a weekend effect became apparent for deaths within seven days.

Across the board, all patients admitted at the weekend for planned surgery were more likely to die within 30 days than those admitted on other days of the week, the study found.

The researchers acknowledged that the number of participating hospitals in this study was small, but that they represented varying models of service delivery.

“Although these results are limited to the small number of participating hospitals, the international nature of our database suggests that this is a systematic phenomenon affecting healthcare providers across borders,” they said in the journal BMJ Quality & Safety.

The researchers suggested that certain diagnoses and procedures may be particularly sensitive to reduced access to test results and diagnostics at weekends.

Similarly, weekend staff may be fewer in number and less experienced, while patients requiring urgent care may have to wait longer.

 

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Readers' comments (2)

  • This is a comfort

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  • So other countries that can afford to have experts on duty during office hours also suffer higher mortality rates when the experts aren't on duty? Quelle surprise!

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