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Weekend Discharge Can Increase Mortality

Death rates on a Sunday were more than twice as high as those on any weekday

Hospital patients are up to a third more likely to die if they are sent home from the hospital on weekends, British research shows.

The study by Aston University in Birmingham of nearly one million hospital patients admitted to the hospital in England between 2000 and 2013 shows far higher mortality rates among those who were discharged on Saturdays and Sundays — especially the elderly.

Overall, death rates on a Sunday were more than twice as high as those on any weekday, with 4.5% of patients dying within 30 days of discharge, compared with less than 2% through the week. When the figures were adjusted to account for variations such as age, gender, and underlying health problems, the overall risk for those discharged on weekends was 14% greater than on a weekday.

The differences were even greater among those who stayed in the hospital at least a week. In such cases, those sent home on weekends had a 34% higher chance of death. Risks increased with age, with the most elderly patients faring the worst if they were discharged on weekends.

Dr. Rahul Potluri, research leader from Aston University's Algorithm for Comorbities, Associations, Length of stay, and Mortality (ACALM) study unit, said: "These findings are really significant. This is the first time we have looked at the impact of being discharged at the weekend on mortality rates, and the findings have got really far-reaching implications for health and social care."

He explained that a number of factors could explain the striking difference between weekday and weekend patient discharges. These include lower levels of consultants working in hospitals on weekends, closures of hospital pharmacies resulting in patients leaving without medication, and limited support from general practitioners, community services, and social care outside regular working hours.

Caroline Abrahams, Charity Director at Age UK, said: "This report should act as an immediate wake-up call as it highlights how vital it is to have the right services in place when an older person leaves hospital. We continue to sleep-walk towards disaster when it comes to caring for the rising number of older people. Anyone being discharged should have access to the appropriate services needed for a safe and proper recovery whether at the weekend or during the week."

Previous studies have found that patients seeking treatment on weekends often receive inadequate care. Research published in July showed hospitals have less than a third of the number of consultants working on emergencies than they do during the week.

Source: Aston University; September 15, 2015.

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