Hospital mortality: The weekend effect and the time between emergency admission and the start of normal inpatient care

Abstract

Abstract Objectives To analyse mortality associated to emergency admissions on weekends and holidays (WE), differentiating whether the patients were admitted to the Internal Medicine department or to the hospital as a whole.Methods Retrospective follow-up study of patients discharged between 2015 and 2019 in: a) the Internal Medicine (IM) department (n = 7656) and b) the hospital as a whole (n = 83146). Logistic regression models were fitted to analyse mortality.Results There was a significant increase in mortality for patients admitted in WE with short stays in IM (48, 72 and 96 hours: OR = 2.50, 1.89 and 1.62, respectively), and hospital-wide (OR = 2.02, 1.41 and 1.13). The highest risk per WE admission occurred on Fridays (stays ≤ 48 hours: OR = 3.92 [95% CI = 2.06–7.48] in IM), with no effect on Sundays. The risk of death increased with the time elapsed from admission until the inpatient department took over care (OR = 5.51 [95% CI = 1.42–21.40] in IM when this time reached 4 days).Conclusions Whether it was MI patients or hospital-wide patients, the risk of death associated with emergency admission in WE increased with the time between admission and transfer of care to the inpatient department; consequently, Friday was the day with the highest risk while Sunday lacked a weekend effect. Healthcare systems should correct this serious problem.