In hospital settings, there have been concerns about clinical care at night or weekends (see references below). At least with liver transplantation, 24/7 care appears to be the rule rather than the exception (Liver Transpl 2012; 18: 558-65).
Using the UNOS database, this study analyzed 94,768 transplants from 1987-2010. Survival rates at 30, 90, and 365 days for nighttime operations: 96%, 93%, and 86% respectively. For weekends, the respective rates were 95%, 92%, and 86%. These rates did not differ from weekday rates. Graft failure rates were modestly increased for weekend transplants at 365 days (HR 1.05, 95% confidence interval 1.01-1.11) but not for 30 days or 90 days. In addition, there was no difference in graft failure between nighttime and weekday transplantations.
- -Clin Gastroenterol & Hepatol 2009; 7: 296., 303. n>400,000 discharges. OR 1.2 for mortality of UGI bleed if on weekend.
- NEJM 2001; 345: 663-668. 3,789,917 admissions (in Canada). Weekend admissions were also associated with significantly higher mortality rates for 23 of the 100 leading causes of death and were not associated with significantly lower mortality rates for any of these conditions.