Weekend emergency patients 'have higher death rate'

Patients admitted to hospital as an emergency at the weekend have a higher chance of dying than those who are brought in during the week, according to a study published today.

The death rate among emergency admissions increased by 7% at the weekend, according to a paper published in the journal Quality and Safety in Healthcare. The authors, from Dr Foster Intelligence and Imperial College, calculate that 3,369 more deaths occurred at the weekend in 2005/06 than would have been expected.

"This is more than the 3,201 killed in road accidents in Great Britain in 2006," they write, although they add: "We acknowledge that this is perhaps an unfair comparison, as it is likely that people dying on the roads are from a much younger age group and will be generally healthier compared with the population of people admitted as an emergency to hospital at the weekend."

Dr Paul Aylin, the senior author of the study, said this was clearly a significant number of people. "We need to get to the bottom of what this means.

"Staffing levels are often lower at weekends, with fewer senior medical staff around, and some specialist services are less available. We believe this may be contributing to the increase in mortality rates on Saturdays and Sundays but we would like to see more research.

"Hospitals have been reassessing the working hours and rotas of their doctors and, considering the impact that staff availability may be having on mortality rates, this is a timely reminder to hospitals that they must take care not to jeopardise the quality and standard of patient care available at weekends when devising new staffing rotas."

The researchers looked at administrative data on 215,054 deaths out of the 4.3 million emergency admissions in 163 hospital Trusts in 2005/6. They found that overall death rates were 5.2% for people admitted at weekends and 4.9% for those admitted on a weekday.

There were higher proportions of deaths at the weekend for patients with conditions including heart attacks, heart failure, stroke, some cancers and aortic aneurysms.

As well as lower staffing levels in hospitals, there may be a reduced service in specialist community and primary care services at the weekend, which the authors say may result in some terminally ill patients being admitted to hospital and dying there at the weekends.

Professor Derek Bell, another of the authors, said: "Clinicians and senior healthcare managers must begin to recognise and address these issues to improve patient care."

But the authors say more research is needed before any firm conclusions can be drawn about the reasons for the increased rate of deaths at the weekend.