Doctors, more than anyone, deserve a quiet weekend whenever possible. Sadly, however, when too many take the weekend off, more people die than otherwise would.
This is called the “weekend effect,” and it has been observed in many countries across the world. Now, a new study published in the British Medical Journal finds that the effect bleeds in to Mondays and Fridays.
Nick Freemantle, at University College London, and his colleagues used information from all hospital admissions with the UK’s National Health Service in the financial year ending 2014. Among the 15.9 million patients admitted in that period, some 290,000—about 1.8%—died within 30 days. Freemantle found that, if the patients were admitted on a Saturday or a Sunday, their likelihood of dying was 10% and 15% more, respectively, than if they were admitted on a Wednesday.
One reason may be that patients admitted on a weekend are sicker. But the increased risk of death persists despite taking in to account factors such as the age of the patients admitted and the severity of their illness.
When put together, it means UK hospitals had 11,000 more deaths than it would have if hospitals worked as fully on weekends as they did on the weekdays. However, despite controlling for as many factors as possible, Freemantle warns that not all of these deaths would have been avoidable.
Previous studies have shown that weekend effect is also visible in the US and Australia. The study replicates the findings from 2012, but the new study goes a step further to find that increased chances of mortality are observed on Mondays and Fridays, too.
The other obvious reason for the effect is not having access to all the resources that are normally available through the week. For instance, a US study found that the chance of death increased on a weekend only in non-emergency surgery. It did not increase if the patient was admitted to an intensive care unit, where staffing levels are the same across the week.
But the reasons could be more complex. A different UK study found that those suffering from stroke had a greater chance of dying if admitted on weekend, but only if the nurse staffing levels were unequal. It did not matter whether a stroke specialist was on a seven-day duty or not.
The exact causes will need more studies to be understood. Regardless, the study offers compelling reasons for better management of hospital admissions on the weekend.