A study published in Emergency Medicine Journal shows that patients admitted in medical emergencies during the weekend are usually older and more dependent as compared to patients admitted on other days of the week. This could explain the high death toll of patients admitted in emergency on weekends.
Staffing levels may also play a role in the higher weekend death rates but the researchers note that the patient profile may be a factor as well. They analysed 536 patients admitted to the acute medical care unit of a large teaching hospital in Belfast in 2012 and compared the profile of these patients between 5pm on Friday and 9am on Monday with patients admitted on other days of the week. In addition, they compared the profile of patients arriving both during the day and night at weekends and on weekdays.
Their analysis did not reveal any major differences in the severity of illness between patients admitted on weekends and weekdays. However, they did find that patients who were admitted during weekends were 3.5 years older on average compared to patients admitted at other times of the week. Weekend patients were also more physically incapacitated with an average score of 3 on the Rankin scale as compared to 2 for weekday patients and more functionally dependent.
The researchers explain, "These findings illustrate major differences in the age and functional dependence of patients admitted to hospital at weekends. This difference in profile may fully or partially explain the increased mortality that has been publicised."
While this study only reflects the experience of one hospital, the researchers still question the belief that there would be any difference in mortality rates if more senior doctors were available on weekends. They believe that the lack of difference in physiological and laboratory markers of illness presented here question the plausibility of this inference. The researchers thus conclude that any arguments regarding the number and seniority of staff during the weekends should be based on solid evidence and should take into account other factors that may have an impact on death rates.
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