Weekend Admissions Are Associated with Higher Risk for Hospital-Acquired Conditions

Paul S. Mueller, MD, MPH, FACP reviewing Attenello FJ et al. BMJ 2015 Apr 15.

In U.S. hospitals, “never events,” such as falls and pressure ulcers, were more common after weekend admissions.

The U.S. Centers for Medicare and Medicaid Services regards serious preventable hospital-acquired conditions as “never events.” In this study, investigators used a nationwide U.S. hospital database to compare risks for 11 serious hospital-acquired conditions after weekend or weekday admissions. The database contained records on 351 million patients who were discharged from 2002 through 2010; 19% were admitted on weekends.

The frequencies of these hospital-acquired conditions were 5.7% for weekend admissions and 3.7% for weekday admissions. The most common hospital-acquired conditions were falls or trauma, pressure ulcers, and catheter-associated urinary tract infections. Adjusted for multiple patient, hospital, and severity-of-admission factors, the probability of experiencing at least one hospital-acquired condition was 21% higher for patients admitted on weekends than for those admitted on weekdays. Notably, occurrence of at least one hospital-acquired condition was associated with significantly higher inpatient charges (mean, US$49,000 vs. $27,000) and prolonged length of stay (mean, 6.6 days vs. 4.5 days).

Citation(s):

Attenello FJ et al. Incidence of “never events” among weekend admissions versus weekday admissions to US hospitals: National analysis. BMJ 2015 Apr 15; 350:h1460.