Studies Show Hospitals Are Deadlier on Nights and Weekends
A number of recent studies show that patients admitted to hospitals on nights and weekends are less likely to receive immediate urgent medical care than those admitted on weekdays.
June 26, 2009 /24-7PressRelease/ -- Studies Show Hospitals Are Deadlier on Nights and Weekends
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A number of recent studies show that patients admitted to hospitals on nights and weekends are less likely to receive immediate urgent medical care than those admitted on weekdays. You are statistically more likely to die if you check into a hospital on a weekend rather than on a weekday. While these studies' conclusions do not generally prove causation, there are a number of factors that may contribute to the lower survival rates on nights and weekends. These include fewer staff on duty, less experienced physicians on duty at these times, tired doctors and nurses, less frequent monitoring of patients, limited access to certain procedures at night and on weekends and slower responses to patient distress.
Journal of the American Medical Association Study
A study published in the February 20, 2008 issue of the Journal of the American Medical Association found that patients who went into cardiac arrest during a hospital stay on a weekday had a higher survival rate than on the weekend or at night. This study examined 86,748 adult cardiac arrests that occurred in 507 hospitals between 2000 and 2007. The researchers at Virginia Commonwealth University defined the day/evening time period as 7:00 a.m. until 10:59 p.m., night from 11:00 p.m. until 6:59 a.m. and weekend from 11:00 p.m. on Friday to 6:59 a.m. on Monday.
Specifically, the study found that the survival rate in hospitals on the weekend was only 17.4 percent and 14.7 percent at night, compared with 20.6 percent during weekdays and weekday evenings. According to the study, if patients were treated on a weekday, they were 41 percent more likely to survive. In addition, the study found that people who experienced cardiac arrest at night were less likely to be monitored than during the day/evening, and that cardiac arrests were less likely to be witnessed at night.
The study's authors noted that generally speaking, hospital staffing is different at night. There are fewer admissions at night, fewer diagnostic and therapeutic procedures done at night and in many cases, less experienced personnel are required to work the night shift. In addition, at night, it is more likely that patients will be seen by an on-duty physician who is covering other doctors' patients. This means that the doctor may not be as familiar with the individual patient's condition, and he or she may not be able to devote sufficient time to each patient because of the large number of people the physician must see.
New England Journal of Medicine Study
A study of patients suffering cardiac arrest that was published in the March 15, 2007 issue of the New England Journal of Medicine found that up to 10 additional people per thousand die after a Saturday or Sunday admission to a hospital. While these numbers may seem small, in the course of a year, the decreased weekend care could amount to several thousand preventable deaths in the U.S.
This study used information from the Myocardial Infarction Data Acquisition System (MIDAS) database and included 231,164 patients who were admitted to hospitals in New Jersey between 1987 and 2002. For all of these patients, acute myocardial infarction was the primary reason for admission and it was their first hospital admission with this diagnosis. The patient data was grouped into four-year intervals, and during the 1999-2002 period, there was a 12.0 percent death rate after 30 days for patients admitted on weekdays compared to 12.9 percent for those admitted on weekends.
The study also found that patients who suffer heart attacks after a weekend admission are less likely to receive the cardiac care and procedures routinely administered during the week. In addition, the percentage of patients who underwent procedures on the day of their admission was smaller on the weekend. For examples, the study found that from 1999 to 2002, only 6.7 percent of patients admitted on the weekend had angioplasty to open arteries on the day of admission compared to 10 percent of weekday admissions.
Other Studies
A number of other studies generally confirm that patients have lower survival rates on nights and weekends. For example, a 2009 study of patients suffering from peptic ulcer-related internal bleeding published in Clinical Gastroenterology and Hepatology, the journal of the American Gastroenterological Association Institute, found a higher weekend mortality rate. In addition, the weekend admission patients were more likely to undergo surgery and more likely to have longer hospital stays than weekday admissions.
Further, a 2007 Canadian study shows that ischemic stroke victims are more likely to die within seven days if they are admitted to a hospital on a Saturday or Sunday. An ischemic stroke occurs when an artery to the brain is blocked. If the artery remains blocked for more than a few minutes, brain cells can begin to die, making immediate medical care critical. In addition, the Canadian researchers found that patients admitted on the weekend had a 14 percent higher risk of dying than those admitted on a weekday. The study is inconclusive about the causes of the difference in mortality rates between weekdays and weekends, though researchers state that one likely cause is the reduction of medical personnel resources on weekends.
A Painful Reality
The statistics are very real for many people, including the family of a 61-year-old registered nurse. The Missouri woman experienced knee problems and was admitted to a hospital for an MRI. After receiving morphine for her pain, she stopped breathing, suffered cardiac arrest and died in the early morning hours after a weekend admission.
A medical malpractice lawsuit filed by Kansas City, Missouri, attorney Leland Dempsey alleges that her death could have been prevented if someone at the hospital had been monitoring her vital signs. Research shows that hospitals staff fewer nurses and doctors on weekends than on weekdays. So few staff members were available at the hospital where the woman died, no one was around to tell her husband of her death.
"The way he found out that his wife of years and years and years was dead, is he found her dead body in a room. That's how he found out. Nobody was waiting at the door to tell him," Dempsey said in a recent television news interview on Fox 4.
Another case involves the death of a 38-year-old mother who died five days after checking into a Missouri rehabilitation hospital. Physical therapy had been a routine part of the woman's life since she had broken her neck in three places in a car accident she survived as a teenager.
After the birth of her son, she fell into a depression and stopped doing her exercises. Her husband urged her to check into the Missouri rehab hospital where she had previously stayed. On the fifth day of her stay, a Sunday, the doctor told her husband that she had died.
"These are preventable tragedies," said Attorney Dempsey.
Conclusion
The studies discussed above show that patient mortality rates at hospitals are higher on nights and weekends. Of course, this does not mean that you should put off going to the hospital until Monday if you start experiencing symptoms on Saturday.
There are many potential reasons for the higher mortality rates during these times including short-staffing, less experienced physicians and nurses on duty and overtired doctors. If you have suffered serious injuries or a loved one has died after a hospitalization, you may wish to speak to an attorney about possible legal options.
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