Analysis of weekend effect on mortality by medical specialty in Helsinki University Hospital over a 14-year period

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Tolvi , M , Mattila , K , Haukka , J , Aaltonen , L-M & Lehtonen , L 2020 , ' Analysis of weekend effect on mortality by medical specialty in Helsinki University Hospital over a 14-year period ' , Health Policy , vol. 124 , no. 11 , pp. 1209-1216 . https://doi.org/10.1016/j.healthpol.2020.07.010

Title: Analysis of weekend effect on mortality by medical specialty in Helsinki University Hospital over a 14-year period
Author: Tolvi, Morag; Mattila, Kimmo; Haukka, Jari; Aaltonen, Leena-Maija; Lehtonen, Lasse
Contributor: University of Helsinki, Department of Ophthalmology and Otorhinolaryngology
University of Helsinki, University of Helsinki
University of Helsinki, Department of Public Health
University of Helsinki, HUS Head and Neck Center
University of Helsinki, University of Helsinki
Date: 2020-11
Language: eng
Number of pages: 8
Belongs to series: Health Policy
ISSN: 0168-8510
URI: http://hdl.handle.net/10138/335331
Abstract: Background: The weekend effect, the phenomenon of patients admitted at the weekend having a higher mortality risk, has been widely investigated and documented in both elective and emergency patients. Research on the issue is scarce in Europe, with the exception of the United Kingdom. We examined the situation in Helsinki University Hospital over a 14-year period from a specialty-specific approach. Materials and methods: We collected the data for all patient visits for 2000-2013, selecting patients with in-hospital care in the university hospital and extracting patients that died during their hospital stay or within 30 days of discharge. These patients were categorized according to urgency of care and specialty. Results: A total of 1,542,230 in-patients (853,268 emergency patients) met the study criteria, with 47,122 deaths in-hospital or within 30 days of discharge. Of 12 specialties, we found a statistically significant weekend effect for in-hospital mortality in 7 specialties (emergency admissions) and 4 specialties (elective admissions); for 30-day post-discharge mortality in 1 specialty (emergency admissions) and 2 specialties (elective admissions). Surgery, internal medicine, neurology, and gynecology and obstetrics were most sensitive to the weekend effect. Conclusions: The study confirms a weekend effect for both elective and emergency admissions in most specialties. Reducing the number of weekend elective procedures may be necessary. More disease-specific research is needed to find the diagnoses most susceptible. (C) 2020 Elsevier B.V. All rights reserved.
Subject: Hospital mortality
Patient discharge
Treatment outcome
Weekend effect
Quality of healthcare
ACUTE MYOCARDIAL-INFARCTION
SHORT-TERM MORTALITY
WEEKDAY ADMISSION
GASTROINTESTINAL HEMORRHAGE
ISCHEMIC-STROKE
AFTER-HOURS
OFF-HOURS
OUTCOMES
CARE
TIME
3141 Health care science
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