Dying for the weekend: a retrospective cohort study on the association between day of hospital presentation and the quality and safety of stroke care.
Approach to Improving Safety
Setting of Care
Multiple prior studies have identified increased mortality, preventable complications, and delays in undergoing urgent procedures for patients admitted to the hospital on the weekend. This phenomenon has been termed the "weekend effect." With this large, retrospective cohort study, evidence of inferior weekend care now includes patients with acute stroke. The study, which involved nearly 100,000 stroke patients admitted to hospitals in the United Kingdom, found significantly lower performance across 5 of 6 quality and safety indicators for patients admitted on the weekend. Most notably, the rate of 7-day in-hospital mortality for Sunday admissions was 11.0%, compared with 8.9% for weekday admission. The authors note that 350 in-hospital deaths may be avoidable each year if care provided on weekends equaled that provided on weekdays.