Journal of Occupational
Health and Epidemiology
Rafsanjan university Of medical sciences
Volume 13, Issue 3 (Summer 2024)
J Occup Health Epidemiol 2024, 13(3): 155-156 |
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Aghakhani N, Mehryar H, Behroozi-Lak T. The Weekend Effect: Unraveling the Mystery Behind Higher Mortality Rates in Healthcare Settings. J Occup Health Epidemiol 2024; 13 (3) :155-156
URL: http://johe.rums.ac.ir/article-1-849-en.html
URL: http://johe.rums.ac.ir/article-1-849-en.html
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1- Associate Prof., Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran. , naderaghakhani2000@gmail.com
2- Assistant Prof., Department of Emergency Medicine, School of Medicine, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.
3- Urmia University of Medical Sciences,Urmia, Iran.
2- Assistant Prof., Department of Emergency Medicine, School of Medicine, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran.
3- Urmia University of Medical Sciences,Urmia, Iran.
Article history
Received: 2024/03/3
Accepted: 2024/06/24
ePublished: 2024/09/28
Accepted: 2024/06/24
ePublished: 2024/09/28
Subject:
Occupational Health
Keywords: No Keywords
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Dear Editor,
The “weekend effect” is an unique phenomenon in healthcare facilities that shows patients admitted to hospitals on weekends tend to have worse outcomes than those admitted on weekdays. This is concerning for hospital administrators, particularly for patients with critical conditions such as stroke and heart attack. Patients admitted on weekends may experience delays in receiving necessary interventions or procedures, potentially increasing rates of negative health outcomes and mortality [1].
This condition has been explored in numerous patient populations and within different healthcare systems worldwide and can be attributed to the reduced availability of skilled nurses, general practitioners, specialists, and on-call physicians, which may lead to challenges in accessing crucial services and a lower quality of care. Furthermore, insufficient provider coverage and limited access to medical examinations and procedures can have negative implications [2,3].
This effect is particularly pronounced in internal medicine, obstetrics, gynecology, neurology, and surgery. Its extent can vary depending on factors such as geographic location, severity of illness, type of admission, and methodological and contextual considerations. For example, on weekends, emergency departments at hospitals receive more emergency cases, particularly those involving severely ill patients such as those from car accidents. This results in differences in care pathways before and after admission that may cause a lack of security, leading to a significant increase in adverse events. Accordingly, healthcare professionals may be exposed to high levels of violence, characterized as events in which they feel scared, mistreated, intimidated, frightened, or attacked, with a negative impact on their health, self-confidence, safety, and psychological and physical well-being [4, 5].
To address this issue and improve patient outcomes, healthcare providers, policymakers, and patients must understand the causes that will enable them to take action and explore innovative solutions, such as providing pre-hospital treatments and centralizing critical steps in healthcare delivery. Consequently, shifting the focus from unadjusted mortality rates to quality indicators and clinical performance is crucial for understanding the impact of weekend admissions. In the future, innovative solutions such as providing therapies before hospital admission and centralizing critical steps in healthcare delivery may enhance outcomes and potentially counteract the effects of weekend admissions [5].
However, the weekend effect produces poor patient outcomes during non-standard healthcare hours. Hospitals need to adjust service availability and care protocols to address this issue. Policymakers should avoid oversimplified solutions and consider the different factors contributing to higher mortality rates on weekends. Healthcare professionals' practice, quality of services, patient outcomes, and organizational factors should all be examined to enhance patient confidence in the healthcare system.
Conflict of interest: None declared.
The “weekend effect” is an unique phenomenon in healthcare facilities that shows patients admitted to hospitals on weekends tend to have worse outcomes than those admitted on weekdays. This is concerning for hospital administrators, particularly for patients with critical conditions such as stroke and heart attack. Patients admitted on weekends may experience delays in receiving necessary interventions or procedures, potentially increasing rates of negative health outcomes and mortality [1].
This condition has been explored in numerous patient populations and within different healthcare systems worldwide and can be attributed to the reduced availability of skilled nurses, general practitioners, specialists, and on-call physicians, which may lead to challenges in accessing crucial services and a lower quality of care. Furthermore, insufficient provider coverage and limited access to medical examinations and procedures can have negative implications [2,3].
This effect is particularly pronounced in internal medicine, obstetrics, gynecology, neurology, and surgery. Its extent can vary depending on factors such as geographic location, severity of illness, type of admission, and methodological and contextual considerations. For example, on weekends, emergency departments at hospitals receive more emergency cases, particularly those involving severely ill patients such as those from car accidents. This results in differences in care pathways before and after admission that may cause a lack of security, leading to a significant increase in adverse events. Accordingly, healthcare professionals may be exposed to high levels of violence, characterized as events in which they feel scared, mistreated, intimidated, frightened, or attacked, with a negative impact on their health, self-confidence, safety, and psychological and physical well-being [4, 5].
To address this issue and improve patient outcomes, healthcare providers, policymakers, and patients must understand the causes that will enable them to take action and explore innovative solutions, such as providing pre-hospital treatments and centralizing critical steps in healthcare delivery. Consequently, shifting the focus from unadjusted mortality rates to quality indicators and clinical performance is crucial for understanding the impact of weekend admissions. In the future, innovative solutions such as providing therapies before hospital admission and centralizing critical steps in healthcare delivery may enhance outcomes and potentially counteract the effects of weekend admissions [5].
However, the weekend effect produces poor patient outcomes during non-standard healthcare hours. Hospitals need to adjust service availability and care protocols to address this issue. Policymakers should avoid oversimplified solutions and consider the different factors contributing to higher mortality rates on weekends. Healthcare professionals' practice, quality of services, patient outcomes, and organizational factors should all be examined to enhance patient confidence in the healthcare system.
Conflict of interest: None declared.
References
1. 1- Duvald I. Exploring reasons for the weekend effect in a hospital emergency department: an information processing perspective. J Organ Des. 2019;8(1):1-27. [DOI]
2. Zhou Y, Li W, Herath C, Xia J, Hu B, Song F, et al. Off-hour admission and mortality risk for 28 specific diseases: a systematic review and meta-analysis of 251 cohorts. J Am Heart Assoc. 2016;5(3):e003102. [DOI] [PMID] [PMCID]
3. Rashidi R, Anbari K, Mohammadi R. Factors Affecting the Level of Nurses' Quality of Life in Khorramabad (IRAN) Teaching Hospital during the COVID-19 Epidemic, in 2020. J Occup Health Epidemiol. 2022;11(2):121-8. [DOI]
4. Chen YF, Armoiry X, Higenbottam C, Cowley N, Basra R, Watson SI, et al. Magnitude and modifiers of the weekend effect in hospital admissions: a systematic review and meta-analysis. BMJ Open. 2019;9(6):e025764. [DOI] [PMID] [PMCID]
5. Nikoonejad A, Aghakhani N. Violence against Female Health Professionals during the COVID-19 Pandemic: A Moral Dilemma. J Occup Health Epidemiol. 2023;12(2):67-8. [DOI]
6. Liu CY, Kung PT, Chang HY, Hsu YH, Tsai WC. Influence of Admission Time on Health Care Quality and Utilization in Patients with Stroke: Analysis for a Possible July Effect and Weekend Effect. Int J Environ Res Public Health. 2021;18(23):12362. [DOI]
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