Weekday versus weekend hospital care

A new study was released saying that tests are delayed on the weekends versus the weekdays.

In the study, published in the August edition of the American Journal of Medicine, researchers analyzed six procedures commonly used in emergency situations:

Purpose

Many hospital departments tend to have lower staffing levels on weekends. We evaluated the use of selected urgent procedures for emergently hospitalized patients and measured the time until procedure based upon the day of hospital admission.

Methods

We analyzed all acute care admissions from all 190 emergency departments in Ontario, Canada, between 1988 and 1997. We selected patients (n = 126,754) who underwent one of six prespecified procedures as their most responsible procedure: fiberoptic bronchoscopy, esophageal gastroduodenoscopy, magnetic resonance imaging, echocardiography, ventilation-perfusion scanning, or coronary angiography. We noted each patient’s day of procedure and day of hospital admission. For waits of less than 8 days, we analyzed the time to procedure based upon the day of admission.

Results

Only 5% (n = 5903) of the urgent procedures were performed on the weekend. Of the six selected procedures, coronary angiography showed the most skewed pattern of performance (1.5% performed on the weekend) and esophageal gastroduodenoscopy showed the least skewed pattern (8% performed on the weekend). Patients admitted on Fridays or Saturdays had the longest waits for procedures. For all six procedures, patients with relatively longer waits had relatively longer total in-hospital stays (P <0.001).

Conclusion

Relatively few urgent procedures are performed in emergently hospitalized patients on the weekend, suggesting that greater attention to weekend care might result in more timely interventions and shorter lengths of stay.

The study was done by Dr. Chaim Bell (who incidentally went to the same high school that I did). He published an earlier study suggesting that mortality was increased on the weekend versus the weekdays. What was always suspected is now empirically studied. There are countless times where tests are delayed solely due to bureaucratic reasons (i.e. skeleton staffing). In addition to tests, simple things like discharge planning and social work are greatly slowed, if not impeded completely, during the weekend.

Disease and treatment does not stop and take a break on weekends. Treating weekends like any other day would be an easy way to decrease length of hospital stay and should offset any increase in staffing costs.

Leave a Comment

Most Popular

✓ Join 150,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.