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Silent night: retrospective database study assessing possibility of "weekend effect" in palliative care
Raymond Voltz1, Robert Kamps2, Ralf Greinwald1
1Department of Palliative Care, University Hospital Cologne, Cologne, Germany.
Objective:
To compare the mortality of patients in a palliative care unit on working days with that on weekends and public holidays.
Design:
Retrospective database study.
Setting:
Palliative care unit in Germany.
Population:
All admissions to palliative care unit between 1 January 1997 and 31 December 2008.
Main Outcome Measure:
The impact of day type (working days or weekends and public holidays) on mortality was analysed using Poisson regression models.
Results:
A total of 2565 admitted patients and 1325 deaths were recorded. Of the deaths, 448 (33.8%) occurred on weekends and public holidays. The mortality rate on weekends and public holidays was 18% higher than that on working days (mortality rate ratio 1.18, 95% confidence interval 1.05 to 1.32; P=0.005).
Conclusion:
Patients in the palliative care unit were at higher risk of dying on weekends and public holidays. In the absence of a prospective study, the exact reasons for this correlation are unclear.
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