Weekend effect on mortality by medical specialty in six secondary hospitals in the Helsinki metropolitan area over a 14-year period

Tolvi, Morag; Mattila, Kimmo; Haukka, Jari; Aaltonen, Leena‐Maija; Lehtonen, Lasse

doi:10.1186/s12913-020-05142-4

Cited by 8 publications

(5 citation statements)

References 34 publications

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“…There are several reports on the association between day of the week and health service outcomes. For example, mortality rates for patients electively admitted on weekends may be worse, specifically in surgery, internal medicine, and genecology and obstetrics 4 . The management of and mortality due to myocardial infarction and cerebral stroke is worse among patients admitted on weekends than among those admitted on weekdays 5,6 .…”

mentioning

confidence: 99%

Impact of the day of the week on the discontinuation of broad-spectrum antibiotic prescriptions; a multi-centered observational study

Honda

Hagiya

Higashionna

et al. 2021

Sci Rep

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To encourage and guide antimicrobial stewardship team (AST) activity and promote appropriate antibiotic use, we studied the impact of day of the week on the initiation and discontinuation of antibiotic administration. This was a multicenter observational study conducted at 8 Japanese hospitals from April 1 to September 30, 2019, targeting patients who underwent treatment with broad-spectrum antibiotics, such as anti-methicillin-resistant Staphylococcus aureus agents and anti-pseudomonal agents. We compared the weekly numbers of initiations and discontinuations of antibiotic prescription on each day of the week or on the days after a holiday. There was no statistical difference in the number of antibiotic initiations on both weekdays and the day after a holiday. However, antibiotic discontinuation was significantly higher from Tuesday onward than Monday and from the second day than the first day after a holiday. Similar trends were observed regardless of the categories of antibiotics, hospital and admission ward, and AST activity. This study suggests that broad-spectrum antibiotics tend to be continued during weekends and holidays and are most likely to be discontinued on Tuesday or the second day after a holiday. This was probably due to behavioral factors beyond medical indications, requiring further antimicrobial stewardship efforts in the future.

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mentioning

confidence: 99%

Impact of the day of the week on the discontinuation of broad-spectrum antibiotic prescriptions; a multi-centered observational study

Honda

Hagiya

Higashionna

et al. 2021

Sci Rep

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“…Regarding the risk factors for reconsultation linked to healthcareassociated AEs, the weekend effect highlighted echoes many studies (19)(20)(21). Some studies did not find this weekend effect, but they did not take traumatology into account, and have been made after a policy of standardization of medical resources between weekdays and weekends was considered (22).…”

Section: Discussionmentioning

confidence: 98%

Healthcare-associated adverse events and readmission to the emergency departments within seven days after a first consultation

Gasperini,

Bouazzi,

Sanchez

et al. 2023

Front. Public Health

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IntroductionThe use of emergency hospital service has become increasingly frequent with a rise of approximately 3.6%. in annual emergency department visits. The objective of this study was to describe the reasons for reconsultations to emergency departments and to identify the risk and protective factors of reconsultations linked to healthcare-associated adverse events.Materials and methodsA retrospective, descriptive, multicenter study was performed in the emergency department of Troyes Hospital and the Sainte Anne Army Training Hospital in Toulon, France from January 1 to December 31, 2019. Patients over 18 years of age who returned to the emergency department for a reconsultation within 7 days were included. Healthcare-associated adverse events in the univariate analysis (p < 0.10) were introduced into a multivariate logistic regression model. Model performance was examined using the Hosmer-Lemeshow test and calculated with c-statistic.ResultsWeekend visits and performing radiology examinations were risk factors linked to healthcare associated adverse events. Biological examinations and the opinion of a specialist were protective factors.DiscussionNumerous studies have reported that a first consultation occurring on a weekend is a reconsultation risk factor for healthcare-associated adverse events, however, performing radiology examinations were subjected to confusion bias. Patients having radiology examinations due to trauma-related pathologies were more apt for a reconsultation.ConclusionOur study supports the need for better emergency departments access to biological examinations and specialist second medical opinions. An appropriate patient to doctor ratio in hospital emergency departments may be necessary at all times.

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“…[1][2][3][4][5] The weekend effect has been demonstrated in several United States and international patient subpopulations. [6][7][8][9] There has been speculation that the weekend effect is attributable to multiple factors including patient case-mix differences (specifically more overdoses and trauma on weekends) and differential staffing on weekends. 4,[10][11][12][13][14] The finding of the presence of a weekend effect has had major impacts as it contributed to controversial expansions in National Health Service staffing.…”

Section: Introductionmentioning

confidence: 99%

Association of Hospital Mortality With Initiation of Mechanical Ventilation on a Weekend: A Retrospective Cohort Study

Rai

Douglas

Mehta

2023

J Intensive Care Med

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Rationale Increased mortality in patients admitted to hospitals on weekends is a well-described phenomenon labeled the “weekend effect.” Studies evaluating the weekend effect in intensive care units (ICUs) have arrived at conflicting results. Identifying a weekend effect for critically-ill patients may inform clinical care pathways and resource allocation. Objectives Determine the association of initiation of mechanical ventilation (MV) upon admission on a weekend versus weekday with hospital mortality. Methods We conducted a retrospective cohort study of non-surgical adult patients using the California Patient Discharge Database from 2018 to 2019. We identified MV initiated on the day of admission and diagnoses using discharge billing codes. The primary exposure was admission and initiation of MV on a weekend versus weekday and the primary outcome was hospital mortality. Hierarchical logistic regression was used to determine the association between hospital mortality and MV initiation timing, adjusting for case-mix. Results Among 90 288 admissions in 2018 and 2019 meeting inclusion criteria, 24 771 (27.5%) had MV initiated on weekends, while 65 517 (72.6%) had MV initiated on weekdays. Patient demographics and comorbidities were similar between groups. Chronic alcohol and substance use disorders, and acute intoxications and traumas were more prevalent among patients with MV initiated on weekends. No difference in hospital mortality was observed with initiation of MV on weekends versus weekdays (23.1% vs 22.8%, ARD = 0.3%, aOR = 1.02, 95% CI 0.98, 1.07). Conclusions Contrary to prior studies, no increased mortality was observed among newly admitted patients initiated on MV on weekends compared to weekdays. While weekend effects may exist in other settings, newly admitted patients likely have MV initiated in the emergency department or ICU, which tend to have more consistent staffing levels. Further research is needed to determine if care patterns in these units could be used as a model for units where weekend effects continue to impact outcomes.

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Weekend effect on mortality by medical specialty in six secondary hospitals in the Helsinki metropolitan area over a 14-year period

Cited by 8 publications

References 34 publications

Impact of the day of the week on the discontinuation of broad-spectrum antibiotic prescriptions; a multi-centered observational study

Impact of the day of the week on the discontinuation of broad-spectrum antibiotic prescriptions; a multi-centered observational study

Healthcare-associated adverse events and readmission to the emergency departments within seven days after a first consultation

Association of Hospital Mortality With Initiation of Mechanical Ventilation on a Weekend: A Retrospective Cohort Study

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