A new study that indicates that patients admitted to hospitals for emergency care on the weekend are somewhat more likely to die than those admitted during the week is understandably unsettling. The report doesn't specifically identify the reasons for increased mortality, but it does suggest that differences in staffing and services offered during the weekend compared to weekdays is a contributing factor. That provides little consolation to those who rely on hospitals for emergency care.
Indeed, patients who enter emergency rooms expect the same level of treatment regardless of when they arrive. They don't always get it, according to a report in the May edition of Archives of Surgery. It's not the first time the weekend phenomenon in a medical setting has been reported, but it is the most far-reaching.
Earlier studies on the difference in patient outcomes for those admitted on the weekend and on a weekday have reported similar results, but the scope of that research was limited. It examined specific diagnoses and circumstances, such as patients in intensive care or those brought to the hospital with a stroke or heart attack on weekends. In those instances, the mortality rate was higher on the weekend than on weekdays. The authors of the newest report wanted to see if that phenomenon was repeated in a broader setting as well. Extensive research showed that it was.
In the researchers' analysis of more than 30 million patients in community hospitals across the country, the mortality rate on weekends was higher - 2.7 percent compared to 2.3 percent on weekdays - for those admitted for emergency care. The mortality rate for 15 of 26 major diagnostic categories was higher on the weekend than during weekdays. It was the same in 10 categories and lower in one. Patients with some types of cancers, with pregnancy and childbirth complications or with female reproductive system disorders had higher mortality on weekends. Those with mental disorders had lower rates.
The vetted study was unable to precisely identify reasons for higher mortality on weekends, but lower staffing levels and reduced experience levels for those working on weekends were suggested factors. That's certainly possible, if not likely.
Whatever the explanation, the increased mortality numbers are disconcerting. There is little an individual can do to beat the odds because no one is ever sure when, where or if they will need emergency care.
Individuals often have little choice for treatment other than the emergency room, whatever the day, if they experience a life-threatening event - heart attack, stroke - or major injury - broken bone, severe lacerations. That's especially the case on weekends when almost all physician offices are closed. Worrisome as the mortality research might be, there is a caveat. While the report covers a broad range of hospitals, it does not provide information on specific emergency rooms. There can be significant differences from one emergency room to another.
Some, especially those designated as trauma centers, have far lower mortality rates than the average. Some, of course, have worse. Problem is, a person in need of immediate and perhaps critical care is unlikely to know the skill and staffing levels of the emergency room to which he or she is headed.
The quick answer to the problem identified by the report is for hospitals on the whole to increase emergency room staffing levels and to have more experienced personnel on duty on the weekends. The reality is that doing so is likely to be so costly that many emergency care providers will be reluctant or unable to do so.