Which is longer weekdays or weekends
You can usually not choose it, but one thing is clear: patients admitted at the weekend often have a higher risk of death in hospitals. Experts now doubt that poor supply is the main cause, as is often assumed.
Coventry (AP) - Hospital patients admitted at the weekend have a higher risk of dying. This has been shown by numerous studies for various countries over the past few years.
This weekend effect is mainly attributed to poorer care in clinics on Saturdays and Sundays - experts now doubt this in a new analysis.
The British research team had reviewed studies on the weekend effect from different countries. No clear cause for the higher mortality rate can be derived from the data, they conclude in the specialist magazine “BMJ Open”. Above all, research must be carried out to determine whether people who come to the emergency room at the weekend are on average more seriously ill than those during the week.
Quality of care
German experts, however, still consider the quality of care to be decisive. There is no scientific evidence for the weekend effect in this country, but experts assume that it also plays a role. The poor staff structure at the weekend is obvious, said Anna Slagman, professor for emergency medical care research at the Charité Berlin.
If patients with more serious illnesses came on the weekends, as the researchers of the study assume, this exacerbates the problem, says Slagman. “Of course, there is a possibility that patients may wait longer on weekends before going to the emergency room. But especially in light of the fact that these patients have a poor prognosis, we have to be able to respond with the appropriate care. "
Ruth Hecker, Deputy Chairwoman of the Patient Safety Action Alliance, also pointed out supply deficits on Saturdays and Sundays. "Most of all, young doctors work on weekends, the specialists are often only available on call and there are fewer operating room and other diagnostic resources available." Politicians have already done a lot to strengthen personnel and resources, but the number of days of the week has not been reached, said Hecker.
The weekend effect
Yen-Fu Chen from the University of Warwick and his team used data from 68 studies on the weekend effect for their analysis. Most of these were carried out in the US and UK between 2000 and 2017. It recorded a total of 640 million weekend hospital stays. The weekend effect was confirmed: the likelihood of dying was 16 percent higher for admitted patients than on working days.
However, the data showed great differences depending on the reason why the patients came to the hospital. For example, there was hardly any weekend effect for pregnant women, but it was very strong in planned operations. Another study conducted at Aston University currently shows that the weekend effect did not occur in patients admitted with cardiac arrest.
Chen and researchers warn against explaining the higher mortality rate solely to poorer care. On the one hand, however, argues that not all patient groups are affected; on the other hand, the data situation is insufficient. In hardly any study was it examined how many staff were on site and with what state of health the patients came to the hospital.
"Fewer patients are admitted to the hospital on the weekend and their profiles differ from those who come during the week: They are sicker and more of them are being treated in intensive care," said Julian Bion, co-author of the study. It is also likely that more complicated operations will be planned for the weekend, according to the researchers.
In order to fathom the weekend effect and take suitable measures against it, the medical history must also be included, according to the authors. For example, many patients are unable to visit a general practitioner on the weekend before going to the hospital. "Hospital mortality is a signal, but it is unknown where it came from and it is unlikely to be a suitable measure of the quality of care during the stay," said first author Yen-Fu Chen.
The researchers also want to use the results to dispel fears of patients: "In the end, no one who gets sick at the weekend should shy away from going to the hospital or postponing it," says Bion.
Link to the study
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