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Health policy
Research
Weekend admissions as an independent predictor of mortality: an analysis of Scottish hospital admissions
  1. Adam E Handel1,2,
  2. Sunil V Patel3,4,
  3. Andrew Skingsley3,5,
  4. Katrina Bramley3,6,
  5. Roma Sobieski3,
  6. Sreeram V Ramagopalan1,2,3,7
  1. 1Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
  2. 2Nuffield Department of Clinical Neurosciences (Clinical Neurology), University of Oxford, Oxford, UK
  3. 3Department of Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
  4. 4Department of Surgery, London Health Sciences Centre, London, Canada
  5. 5Department of Epidemiology and Public Health, Imperial College Medical School. London, UK
  6. 6Department of Anaesthesia, Glasgow Royal Infirmary, Glasgow, UK
  7. 7Blizard Institute, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, London, UK
  1. Correspondence to Dr Sunil V Patel; Sunil.Patel{at}londonhospitals.ca, Dr Sreeram V Ramagopalan; s.ramagopalan{at}qmul.ac.uk

Abstract

Objectives Weekend admissions have been shown to be associated with an increased risk of mortality compared with weekday admissions for many diagnoses. We analysed emergency department admissions within the Scottish National Health Service to investigate whether mortality is increased in case of weekend emergency department admissions.

Design A cohort study.

Setting Scotland National Health Service (NHS) emergency departments.

Participants 5 271 327 emergency department admissions between 1999 and 2009. We included all patients admitted via emergency departments recorded in the Scottish Morbidity Records (SMR01) in NHS, Scotland for whom complete demographic data were available.

Primary outcome measures Death as recorded by the General Register Office (GRO).

Results There was a significantly increased probability of death associated with a weekend emergency admission compared with admission on a weekday (unadjusted OR 1.27, 95% CI 1.26 to 1.28, p<0.0001; adjusted for year of admission, gender, age, deprivation quintile and number of comorbidities OR 1.42, 95% CI 1.40 to 1.43, p<0.0001).

Conclusions Despite a general reduction in mortality over the last 11 years, there is still a significant excess mortality associated with weekend emergency admissions. Further research should be undertaken to identify the precise mechanisms underlying this effect so that measures can be put in place to reduce patient mortality.

  • Accident & Emergency Medicine

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjopen-2012-001789

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