‘Weekend effect’ not a reliable measure of care

A new study has claimed that the higher mortality rate for weekend hospital admissions should not be used as an indicator of quality of care.

Due to the lack of data preceding patient admission and on the severity of their illness, the University of Warwick says that the data, used by former Health Secretary Jeremy Hunt to campaign for longer working hours for NHS staff, as ‘sparse and somewhat conflicting’.

Researchers from Warwick Medical School and Birmingham examined 68 studies covering data from over 640 million hospital admissions across the world and concluded that, contrary to commonly held assumptions, the higher death rates amongst patients admitted to hospital at weekends are unlikely to reflect in-hospital quality of care, and may be attributed to differential criteria for admitting patients and other factors in the community preceding hospital admission.

While hospital mortality was found to be 16 per cent higher for weekend admissions compared with weekday admissions on average, they noticed that such a ‘weekend effect’ varied by type of admissions, with the effect being most pronounced for elective admissions and almost absent for maternity admissions.

The researchers found little association between weekend-weekday differences in staffing level and weekend-weekday differences in hospital mortality in the small number of studies that looked into this, and suggest that there are other factors affecting the mortality that should be investigated further.