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The impact of weekends on outcome for emergency patients

L Schmulewitz, A Proudfoot and D Bell
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DOI: https://doi.org/10.7861/clinmedicine.5-6-621
Clin Med November 2005
L Schmulewitz
St George's Hospital, London
Roles: Senior House Officer in Cardiology
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A Proudfoot
Northwick Park Hospital, Harrow
Roles: Registrar in Respiratory and General Medicine
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D Bell
Royal Infirmary of Edinburgh
Roles: Associate Clinical Director
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Abstract

Levels of staffing and access to diagnostics at weekends are recognised to be significantly lower than on weekdays. It is unclear if subsequent inpatient mortality and readmission rates for acute medical admissions are increased for weekend admissions compared to those on a weekday. A large Canadian study demonstrated increased weekend mortality but does the Edinburgh healthcare model support these findings? This study analysed all hospital admissions in 2001 to the Royal Infirmary of Edinburgh for six predetermined diagnoses (total 3,244): chronic obstructive pulmonary disease, cerebrovascular accidents, pulmonary embolism, pneumonia, collapse and upper gastrointestinal bleed. We compared hospital mortality rates, readmission rates and hospital length of stay for weekend admissions as compared to those on a weekday. Weekend admission was not associated with significantly higher in-hospital mortality, readmission rates or increased length of stay compared to the weekday equivalent for any of the six conditions. The implementation of an acute medical admissions unit in the Royal Infirmary of Edinburgh, with consistent staffing levels and 24-hour access to diagnostics for the early phase of critical illness, may have helped address the discrepancy in care suggested by previous studies.

  • hospital mortality
  • length of stay
  • levels of staffing
  • medical admissions units
  • outcome assessment
  • readmission rates
  • weekday admission
  • weekend admission
  • © 2005 Royal College of Physicians
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The impact of weekends on outcome for emergency patients
L Schmulewitz, A Proudfoot, D Bell
Clinical Medicine Nov 2005, 5 (6) 621-625; DOI: 10.7861/clinmedicine.5-6-621

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The impact of weekends on outcome for emergency patients
L Schmulewitz, A Proudfoot, D Bell
Clinical Medicine Nov 2005, 5 (6) 621-625; DOI: 10.7861/clinmedicine.5-6-621
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