New research in the UK challenges the assumption that people admitted to hospitals on Saturday or Sunday are more likely to die than those admitted Monday to Friday (‘weekend effect’). It had been assumed that extra deaths occur because fewer hospital consultants are present at weekends than during the week. The new research by National Institute for Health and Care Research shows that people admitted as emergencies at weekends are sicker and more likely to be near the end of life than those who come in during the week. The large 5-year study found hospital care at the weekend is, if anything, better than weekday care. However, markers of community care were worse at weekends than on weekdays.
The study found that the numbers of consultants did not account for the weekend effect. There was no evidence that errors in hospital care were more common at weekends. Over the course of the study, consultants worked increasing hours in hospital at the weekends caring for emergency admissions. But this increase in their hours was overtaken by the increase in the numbers of people admitted at the weekends. Researchers concluded the weekend effect is likely to be a result of insufficient care in community settings at the weekend.
This large study brought together information from different sources. Researchers studied national trends on how many patients died in hospital or soon after they had gone home. They surveyed specialists at 115 Trusts about their working patterns; they interviewed hospital staff and patients at 20 Trusts about their experiences. Data on emergency admissions to one large NHS Trust included a score of how severely ill patients were (based on routinely collected information such as temperature and blood pressure). Senior doctors also reviewed case notes covering 4,000 emergency admissions to 20 hospitals. They looked for errors, adverse events and assessed the overall quality of care.
- Emergency care in hospitals is as good at the weekend as on weekdays. NIHR. April 2022