Weekend effect

The phenomenon of increased mortality and adverse outcomes for patients admitted to hospitals on weekends

This figure shows the change in mortality for stroke patients over 30 days in a UK sample as the number of nurses relative to the number of beds in the hospital changes, adjusting for various covariates.

The weekend effect is a phenomenon observed in healthcare where patients admitted to hospitals during the weekend experience worse outcomes compared to those admitted on weekdays. This effect is characterized by higher mortality rates, increased complication rates, and longer hospital stays for weekend admissions. The weekend effect has been a subject of extensive research and debate within the medical community.

Causes

Several factors have been proposed to explain the weekend effect:

• Staffing Levels: Hospitals often have reduced staffing levels during weekends, which can lead to delays in diagnosis and treatment. There may be fewer specialists and consultants available, which can impact the quality of care.

• Resource Availability: Diagnostic and therapeutic resources, such as imaging services and surgical teams, may be less available on weekends, leading to delays in necessary procedures.

• Patient Characteristics: Some studies suggest that patients admitted on weekends may have different characteristics, such as more severe conditions or different socioeconomic status, which could contribute to worse outcomes.

• Continuity of Care: The transition of care between weekday and weekend staff can lead to communication issues and discontinuity in patient management.

Impact on Patient Outcomes

The weekend effect has been associated with various adverse outcomes, including:

• Increased mortality rates for certain conditions, such as stroke, myocardial infarction, and trauma.
• Higher rates of complications, such as infections and surgical complications.
• Longer length of stay in the hospital, which can increase healthcare costs and resource utilization.

Strategies to Mitigate the Weekend Effect

Healthcare systems have implemented several strategies to address the weekend effect:

• Improved Staffing: Increasing the number of healthcare professionals available on weekends, including nurses, physicians, and specialists.

• Enhanced Communication: Implementing better communication protocols to ensure continuity of care between weekday and weekend staff.

• Resource Allocation: Ensuring that critical diagnostic and therapeutic resources are available throughout the weekend.

• Standardized Protocols: Developing and adhering to standardized treatment protocols to reduce variability in care.

Controversies and Criticisms

The existence and extent of the weekend effect have been debated. Some researchers argue that the effect is overstated or that it varies significantly between different healthcare systems and regions. Others suggest that improvements in hospital processes and staffing have mitigated the effect in recent years.

Related pages

• Hospital mortality
• Patient safety
• Healthcare quality
• Emergency medicine

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