'Weekend effect' on hospital care quality a myth, study suggests

The "weekend effect," defined as differences in patient outcomes for those admitted on weekends compared to admissions on weekdays, may not be a "reliable indicator of care quality" on weekends, according to a study published in BMJ Open.

Researchers reviewed seven databases for studies investigating the weekend effect on mortality, adverse events, length of hospital stay or patient satisfaction. They searched the databases from January 2000 to April 2015, and updated the search in one database, Medline, to include studies through November 2017.

They included 68 studies involving 640 million admissions. Of these, 24 were conducted in the United Kingdom and 22 in the United States.

Researchers found that on weekends:

• Fewer patients are admitted to hospital
• Those who are admitted are more severely ill
• There are differences in care pathways before and after admission

The evidence regarding the weekend effect on adverse events and length of stay is "weak and inconsistent, and that on patient satisfaction is sparse," authors wrote.

Additionally, researchers observed that the weekend effect appeared greater for elective than emergency or maternity procedures.

"The weekend effect is unlikely to have a single cause, or to be a reliable indicator of care quality at weekends," study authors concluded.

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