Weekday <i>vs</i> weekend endoscopy: Is there a true difference in patient outcomes? A meta-analysis

Hinds, Alisha; Ahmad, Dina; Lopez, Kristi; Matteson-Kome, Michelle L.; Bechtold, Matthew L.

doi:10.13105/wjma.v2.i2.29

Cited by 1 publication

(4 citation statements)

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“…The literature reflects mixed evidence of inequitable outcomes associated with hospital care outside of hours or at the weekend. [4][5][6] Since a landmark study in 2001, 1 over 100 papers have explored the The literature investigating outcome differences for ED patients seeking care out-of-hours mostly considers patients admitted through ED, 1,[25][26][27] mortality and the 'weekend effect'. While outcomes for inpatients form a valuable evidence base, they represent only a fraction of all hospital outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The literature reflects mixed evidence of inequitable outcomes associated with hospital care outside of hours or at the weekend 4–6 . Since a landmark study in 2001, 1 over 100 papers have explored the difference in outcome across a range of patient populations and health systems.…”

Section: Discussionmentioning

confidence: 99%

“…There is mixed evidence of inequitable outcomes associated with hospital care outside of hours or at the weekend. [4][5][6] While many studies report admission outside of hours and at weekends is associated with higher mortality or other adverse outcomes, 2,3 others report either no impact 7,8 or mixed outcomes. 1,4,[9][10][11] Within Queensland, Australia (population approximately 5 million), and based on the mixed evidence associated with hospital care outside of hours, the Queensland Clinical Senate recommended the Department of Health conduct a comprehensive evidence-based review of the issue in a Queensland context.…”

Section: Introductionmentioning

confidence: 99%

“…Previous research 1–3 has generated substantial interest and debate into the question of whether health outcomes differ for patients receiving healthcare outside of normal business hours, such as weekends (‘the weekend effect’). There is mixed evidence of inequitable outcomes associated with hospital care outside of hours or at the weekend 4–6 . While many studies report admission outside of hours and at weekends is associated with higher mortality or other adverse outcomes, 2,3 others report either no impact 7,8 or mixed outcomes 1,4,9–11 …”

Section: Introductionmentioning

confidence: 99%

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After‐hours emergency department care: Does time or day of arrival affect survival?

Rolls

Khanna

Boyle

et al. 2020

Emerg Medicine Australasia

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Objective To determine whether after‐hours presentation to EDs is associated with differences in 7‐day and 30‐day mortality. The influence of patient case‐mix and workforce staffing differences are also explored. Methods We conducted a retrospective observational study of 3.7 million ED episodes across 30 public hospitals in Queensland, Australia during May 2013–September 2015 using routinely collected hospital data linked to hospital staffing data and the death registry. Episodes were categorised as within/after‐hours using time of presentation. Staffing was derived from payroll records and explored by defining 11 staffing ratios. Results Weekend presentation was slightly more associated (7‐day mortality odds ratio 1.05, 95% confidence interval [CI] 1.01–1.10) or no more associated (30‐day mortality odds ratio 1.01, 95% CI 0.98–1.03) with death than weekday presentation. When weeknights are included in the ‘after‐hours’ period, odds ratios are smaller, so that after‐hours presentation is no more associated (7‐day mortality odds ratio 1.03, 95% CI 0.99–1.08) or less associated (30‐day mortality odds ratio 0.95, 95% CI 0.93–0.97) with death. No significant after‐hours patient case‐mix differences were observed between weekday and weekend presentations for 7‐day mortality. In other combinations of outcome and after‐hours definition, some differences (especially measures relating to severity of presenting condition) were found. Staffing ratios were not strongly associated with any within/after‐hours differences in ED mortality. Conclusions After‐hours presentation on the weekend to an ED is associated with higher 7‐day mortality even after controlling for case‐mix.

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