The “weekend effect” is a term used to indicate that outcomes for many medical conditions are worse when patients are admitted to the hospital on the weekend.
A recent study (MD Egberg et al. Inflamm Bowel Dis 2020; 26: 254-60; editorial by C Ballengee Menchini 261-2) documents the degree of this effect on the risk of complications for pediatric patients with inflammatory bowel disease (IBD).
This study used a cross-sectional analysis with the Kids’ Inpatient Database (KID), a nationally representative database. The study included 3255 urgent surgical hospitalizations and included patients 18 years old and younger.
Key findings:
- The risk difference for weekend Crohn’s disease (CD) surgical hospitalizations involving a complication vs weekday hospitalizations was 4%
- The risk difference for weekend ulcerative colitis (UC) surgical hospitalizations involving a complication vs weekday hospitalizations was 7%
- The relative risk of surgical complications was 30% and 70% higher for weekend admissions for CD and UC respectively
- For both weekend and weekday admissions, the most common complications were ‘postoperative intestinal/hepatic complications,’ ileus and sepsis
- Hospital teaching status and population-density did not affect outcomes
Possible Reasons for Weekend Effect:
- Reduced hospital staffing
- Delayed seeking care by patients which increases illness severity
- Reduced access to diagnostic resources
- Lack (or reduced) of access to specialist care
Limitations include reliance on administrative data and potential for misclassification and unidentified confounding variables.
Related blog post:
- Weekend Effect –From the Other Side of the Bed
- Good care 24/7 | gutsandgrowth
- The Indispensable Physician | gutsandgrowth
From Weekend Hike on Mount Yonah: