Mortality and other outcomes after paediatric hospital admission on the weekend compared to weekday

Area of Science:

• Pediatric Medicine
• Hospital Administration
• Public Health

Background:

• Adults admitted to hospital and babies born on weekends experience higher mortality.
• Previous research suggests potential disparities in healthcare outcomes based on admission day.

Purpose of the Study:

• To compare in-hospital mortality rates for pediatric patients admitted on weekends versus weekdays.
• To investigate the association between admission day and the need for intensive care unit (ICU) or high dependency unit (HDU) care in children.

Main Methods:

• Retrospective analysis of acute medical admissions for children aged ≤16 years in Scotland (2000-2013).
• Data linkage of admission records with death records to determine mortality.
• Statistical analysis using adjusted odds ratios (aOR) to compare weekend versus weekday outcomes.

Main Results:

• No statistically significant increase in in-hospital mortality was observed for children admitted on weekends (aOR 1.03; 95% CI 0.80 to 1.32).
• Children admitted on weekends had a higher odds ratio for requiring ICU or HDU care (OR 1.24; 95% CI 1.16 to 1.32).
• Absolute daily admissions to ICU/HDU were similar, suggesting fewer less severe admissions on weekends explain the higher proportion of severe cases.

Conclusions:

• There is no evidence of increased in-hospital pediatric mortality associated with weekend admissions.
• The higher rate of ICU/HDU admissions on weekends is likely due to a lower volume of less severe cases, not increased mortality risk.