Since 2001, more than 100 studies have explored whether the "weekend effect" exists, whereby outcomes are worse for patients admitted to the hospital over the weekend compared to those admitted during weekdays, but more studies need to examine why, according to a recent editorial published in BMJ Quality & Safety.
The editorial was authored by University Warwick Medical School Professor Richard Lilford, PhD, and senior research fellow Yen-Fu Chen, PhD, in Coventry, U.K.
According to the authors, "Understanding the weekend effect is an extremely important task since it…amounts to about 160 additional deaths in a hospital with 40,000 discharges per year."
To explicate why the weekend effect exists, the authors suggest the following four approaches.
1. Use more detailed analyses of databases. Differences in case-mix and service quality may affect the outcomes during the weekends, so analyzing larger datasets may provide clues to the causes of differing casualty rates.
2. Directly examine care quality during weekdays and over weekends. Quantitative and qualitative observations of the quality of clinical care over the weekend may shed some light on the likelihood of preventable adverse events.
3. Conduct disease-specific studies. There are both theoretical grounds and empirical evidence to suggest that weekend effect on mortality is more likely to occur in certain conditions, such as cardiac arrhythmia and pulmonary embolism. Breaking down studies by disease may help elucidate the weekend effect.
4. Conduct intervention studies. To find further evidence of the weekend effect and the necessary actions to mitigate it, researchers should evaluate studies alongside the introduction of an intervention, such as a policy that incentivizes hospitals to increase consultant cover over weekends.
More articles on patient outcomes and the weekend effect:
How hospitals use big data to improve quality, outcomes: 3 takeaways
5 ways hospitals can combat the 'weekend effect' of longer stays, higher mortality
Risk of patient harm in hospitals spikes on the weekends