study reaffirms that weekend effect continues in many us hospitals

A few weeks ago, our blog discussed the so-called “July effect,” meaning the phenomenon of medical mistakes increasing during the month of July since that’s when experienced medical professionals move on to new roles, and leave the majority of patient care to inexperienced interns. As if that wasn’t frightening enough, researchers at Johns Hopkins recently released a study suggesting that the “weekend effect” is also alive and well in many U.S. hospitals.

Past studies have suggested that outcomes for patients who have suffered strokes, heart attacks or aneurisms were decidedly more negative on the weekend. Now, a recently published study in the Journal of Surgical Research is suggesting that the same holds true for older patients who enter the hospital for head trauma or a brain injury on the weekend.

The authors arrived at this conclusion by examining data from the U.S. Department of Health and Human Services’ Healthcare Cost and Utilization project from 2006 to 2008. Specifically, they looked at the records of 38,675 people between the ages of 65 and 89 who were admitted to hospitals for treatment for head trauma. 25 percent of these records were for patients admitted on the weekend.

The researchers determined that those older patients admitted for treatment for head trauma on the weekends were 14 percent more likely than their weekday counterparts to die from their injuries. Even more disturbing, the data also revealed that this held true even though weekend patients’ head trauma/brain injuries were less severe and had fewer preexisting illnesses.

What’s behind this shocking finding? Surely, there’s some reasonable explanation as to why severely injured patients are so much more likely to die if admitted on the weekend.

On the contrary. “There isn’t a medical reason for worse results on weekends,” said Eric B. Schneider, Ph.D., an epidemiologist and one of the primary authors of the study. “It’s more likely a difference in how hospitals operate over the weekend as opposed to during the week, meaning that there may be a real opportunity for hospitals to change how they operate and save lives.”

The researchers suggest that one solution may be for hospitals to maintain weekday staffing levels seven days a week. That way, more experienced physicians and nurses would be readily available to help treat patients. However, they acknowledge that cost constraints may prevent this from occurring. In these cases, they suggest that emergency medical personnel transport these kinds of patients directly to trauma centers or those facilities that can provide the requisite level of care.

In other words, patients are more likely to die because hospitals cut costs by reducing staffing expense on the weekend. This is unacceptable. People can’t put off their emergency medical needs until a time that’s more convenient or cost effective for the hospitals. Here’s to hoping that hospitals here in Pennsylvania and across the nation take this study — and the many others just like it — to heart, remembering that patients come before profits.

Source: Johns Hopkins Medicine, “Weekend hospital stays prove more deadly than other times for older people with head trauma,” Aug. 6, 2012

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