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Effects of weekend admission and hospital teaching status on in-hospital mortality.
Am J Med. 2004 Aug 01; 117(3):151-7.AJ

Abstract

PURPOSE

The effect of reduced hospital staffing during weekends on in-hospital mortality is not known. We compared mortality rates between patients admitted on weekends and weekdays and whether weekend-weekday variation in rates differed between patients admitted to teaching and nonteaching hospitals in California.

METHODS

The sample comprised patients admitted to hospitals from the emergency department with any of 50 common diagnoses (N = 641,860). Mortality between patients admitted on weekends and those admitted on weekdays (the "weekend effect") was compared. The magnitude of the weekend effect was also compared among patients admitted to major teaching, minor teaching, and nonteaching hospitals.

RESULTS

The adjusted odds of death for patients admitted on weekends when compared with weekdays was 1.03 (95% confidence interval [CI]: 1.01 to 1.06; P = 0.0050). Three diagnoses (cancer of the ovary/uterus, duodenal ulcer, and cardiovascular symptoms) were associated with a statistically significant weekend effect. None of the 50 diagnoses demonstrated a statistically significant reduction in mortality for weekend admissions as compared with weekday admissions. Mortality was similar among patients admitted to major (odds ratio [OR] = 1.06; 95% CI: 0.94 to 1.19) and minor (OR = 1.03; 95% CI: 0.97 to 1.09) teaching hospitals, compared with nonteaching hospitals. However, the weekend effect was larger in major teaching hospitals compared with nonteaching hospitals (OR =1.13 vs. 1.03, P = 0.03) and minor teaching hospitals (OR = 1.05, P = 0.11).

CONCLUSION

Patients admitted to hospitals on weekends experienced slightly higher risk-adjusted mortality than did patients admitted on weekdays. While overall mortality was similar for patients admitted to all hospital categories, the weekend effect was larger in major teaching hospitals and is cause for concern.

Authors+Show Affiliations

Division of General Internal Medicine, Department of Internal Medicine, University of Iowa College of Medicine, Iowa City 52242, USA. peter.cram@uiowa.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

15276592

Citation

Cram, Peter, et al. "Effects of Weekend Admission and Hospital Teaching Status On In-hospital Mortality." The American Journal of Medicine, vol. 117, no. 3, 2004, pp. 151-7.
Cram P, Hillis SL, Barnett M, et al. Effects of weekend admission and hospital teaching status on in-hospital mortality. Am J Med. 2004;117(3):151-7.
Cram, P., Hillis, S. L., Barnett, M., & Rosenthal, G. E. (2004). Effects of weekend admission and hospital teaching status on in-hospital mortality. The American Journal of Medicine, 117(3), 151-7.
Cram P, et al. Effects of Weekend Admission and Hospital Teaching Status On In-hospital Mortality. Am J Med. 2004 Aug 1;117(3):151-7. PubMed PMID: 15276592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of weekend admission and hospital teaching status on in-hospital mortality. AU - Cram,Peter, AU - Hillis,Stephen L, AU - Barnett,Mitchell, AU - Rosenthal,Gary E, PY - 2003/06/18/received PY - 2004/02/03/accepted PY - 2004/7/28/pubmed PY - 2004/8/21/medline PY - 2004/7/28/entrez SP - 151 EP - 7 JF - The American journal of medicine JO - Am J Med VL - 117 IS - 3 N2 - PURPOSE: The effect of reduced hospital staffing during weekends on in-hospital mortality is not known. We compared mortality rates between patients admitted on weekends and weekdays and whether weekend-weekday variation in rates differed between patients admitted to teaching and nonteaching hospitals in California. METHODS: The sample comprised patients admitted to hospitals from the emergency department with any of 50 common diagnoses (N = 641,860). Mortality between patients admitted on weekends and those admitted on weekdays (the "weekend effect") was compared. The magnitude of the weekend effect was also compared among patients admitted to major teaching, minor teaching, and nonteaching hospitals. RESULTS: The adjusted odds of death for patients admitted on weekends when compared with weekdays was 1.03 (95% confidence interval [CI]: 1.01 to 1.06; P = 0.0050). Three diagnoses (cancer of the ovary/uterus, duodenal ulcer, and cardiovascular symptoms) were associated with a statistically significant weekend effect. None of the 50 diagnoses demonstrated a statistically significant reduction in mortality for weekend admissions as compared with weekday admissions. Mortality was similar among patients admitted to major (odds ratio [OR] = 1.06; 95% CI: 0.94 to 1.19) and minor (OR = 1.03; 95% CI: 0.97 to 1.09) teaching hospitals, compared with nonteaching hospitals. However, the weekend effect was larger in major teaching hospitals compared with nonteaching hospitals (OR =1.13 vs. 1.03, P = 0.03) and minor teaching hospitals (OR = 1.05, P = 0.11). CONCLUSION: Patients admitted to hospitals on weekends experienced slightly higher risk-adjusted mortality than did patients admitted on weekdays. While overall mortality was similar for patients admitted to all hospital categories, the weekend effect was larger in major teaching hospitals and is cause for concern. SN - 0002-9343 UR - https://www.unboundmedicine.com/medline/citation/15276592/Effects_of_weekend_admission_and_hospital_teaching_status_on_in_hospital_mortality_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002934304002475 DB - PRIME DP - Unbound Medicine ER -