Clinical research studyComplication Rates on Weekends and Weekdays in US Hospitals
Section snippets
Data Sources
We collected state administrative inpatient data from 1999 to 2001 for New York and Massachusetts, and from 2000 to 2001 for North Carolina. The data were obtained from the Healthcare Utilization Project’s State Inpatient Databases, which are a compilation of data from participating states containing the universe of those states’ nonfederal hospital discharge abstracts.15 These databases have been used extensively in health services and outcomes research.15, 16, 17, 18 They contain standardized
Characteristics of the Population
We collected data on 4,967,114 admissions of patients at risk for at least 1 of the 8 study complications during our study period. The baseline characteristics of patients who were at risk for a complication on weekends compared with weekdays are shown in Table 2. Patients admitted on weekends constituted 14.8% of the total number of admissions and, on average, were younger and less likely to be white. Table 3 shows the distribution of complications by type and state. We detected 114,090
Discussion
This study aimed to add to the existing debate about the safety of hospital care on weekends by looking at specific complications rather than mortality. We analyzed data from approximately 5 million hospital admissions in 3 states and found small but significantly increased rates of several types of complications on weekends for surgical, newborn, and obstetric patients. We also found complications related to anesthesia occurred less frequently on weekends, and 3 complications for which there
Conclusion
We present evidence that weekend care affects the rates of few complications in acute care hospitals. This increase is mostly small but pronounced for cesarean sections and vascular procedures. We believe it may be explained by hospital staffing structures and resource use. However, although changes to these underlying issues occur slowly, hospitals and some health care providers should be aware of the increased weekend rates of complications and take steps to improve patient safety.
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