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Mortality rate after nonelective hospital admission
Rocco Ricciardi1, Patricia L Roberts, Thomas E Read
1Lahey Clinic, Department of Colorectal Surgery, Tufts University Medical School, 41 Mall Rd, Burlington, MA 01805, USA. rocco.ricciardi@lahey.org
Archives of Surgery (Chicago, Ill. : 1960)
|May 18, 2011
Summary
Hospital mortality is higher for nonelective admissions on weekends compared to weekdays. This weekend effect, indicating worse patient outcomes, may stem from differences in hospital staffing and services.
Area of Science:
- Health Services Research
- Hospital Quality Improvement
- Patient Safety
Background:
- Nonelective hospital admissions represent a critical patient population requiring timely and consistent care.
- Previous studies suggest potential disparities in healthcare quality between weekday and weekend hospital services.
Purpose of the Study:
- To investigate the hypothesis that mortality rates are elevated for nonelective hospital admissions occurring during weekends compared to weekdays.
- To quantify the association between weekend admissions and inpatient mortality, adjusting for various patient and hospital factors.
Main Methods:
- Retrospective cohort analysis of over 29 million patients admitted to US community hospitals between 2003 and 2007.
- Utilized the Nationwide Inpatient Sample to compare inpatient mortality rates for nonelective admissions on weekends versus weekdays.
- Adjusted for diagnoses, demographics, comorbidities, and hospital characteristics.
Main Results:
- A significantly higher inpatient mortality rate was observed for nonelective admissions during weekends (2.7%) compared to weekdays (2.3%).
- The weekend effect was significant across 15 of 26 major diagnostic categories.
- Adjusted analysis revealed a 10.5% higher odds of mortality for weekend admissions (OR, 1.10; 95% CI, 1.10-1.11).
Conclusions:
- Nonelective hospital admissions during weekends are associated with significantly worse patient outcomes, including higher mortality.
- Potential contributing factors include differences in hospital staffing levels and service availability during weekends.
- These findings highlight a mutable aspect of hospital care that may be amenable to quality improvement interventions.
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