Weekend hospital admissions lead to 24% higher death rates

Big variations on survival rates are highlighted

YOUR chances of dying if you are admitted to a Leicester hospital trust at the weekend are nearly a quarter higher than if you are arrived midweek, new figures show.

For admissions to University Hospitals of Leicester between 1 April 2015 and 31 March 2016, your chances of dying within 30 days of admission at the weekend are 24% higher than your chances of dying within 30 days if you are admitted midweek, a significant increase.

NHS Digital analysis suggests that patients in England who are admitted at the weekend have an increased chance of dying within 30 days of admission compared to those who are admitted midweek.

It also suggests that patients who are discharged on Friday, Saturday and Sunday have an increased likelihood of an emergency readmission within seven days of discharge compared to those who are discharged on a Wednesday, and those patients who are admitted in an emergen- cy stay slightly longer in hospital if they are admitted between Friday and Sunday.

The analysis says there are many possible explanations for this variation including differences in the case-mix of patients (over and above that accounted for in the analysis), patient behaviour and provision of services both in and outside of the hospital (including social care), but the analysis is unable to determine the causes of the observed variation.

One of the proposals under the Department of Health policy on seven-day NHS services is to provide the same level of hospital care at the weekend so people have the same experience regardless of day of the week.

For admissions between 1 April 2015 and 31 March 2016, your chances of dying within 30 days of admission at the weekend are 15% higher than your chances of dying within 30 days if you are admitted midweek.

The analysis says this does imply that the chance of dying within 30 days of an admission at the weekend is higher than for midweek admissions, but it does not mean that this probability is 15% higher.

Of the 137 trusts included in the indicator, at 79 (58%) the chances of dying within 30 days of admissions at the weekend was significantly higher than for admissions midweek.

For discharges between 1 April 2015 and 31 March 2016, the chances of an emergency readmission within seven days for discharges on Friday were 9% higher than for those on a Wednesday, 27% higher for Saturday and 40% higher for a Sunday discharge. For discharges following an emergency admission these were 3%, 10% and 11% respectively.

There was a similar likelihood of being readmitted as there was on a Wednesday if a person was discharged on a Monday, Tuesday and Thursday.

Of the 133 trusts included in the indicator, 105 (79%) show a significantly higher chance of a readmission following a discharge on a Saturday, compared to discharge on a Wednesday, and at 113 (85%) it was significantly higher for Sunday discharges. In comparison just three show a significantly higher chance of readmission for a Tuesday discharge compared to a Wednesday discharge.

Nationally, there is a small amount of variation in the distribution of length of stay by day of admission, ranging from 48% of discharges following an emergency admission on a Saturday having a length of stay of zero or one days to 53% of discharges following an emergency admission on a Thursday having a length of stay of 0 or 1 days, a range of five percentage points.

The median length of stay is slightly higher for emergency admissions on Fridays, Saturdays and Sundays (two days) than for emergency admissions on other days of the week (one day). However, as the percentage of spells having a length of stay of zero or one days is close to 50% for each day of the week, caution should be taken when interpreting these median values.

Trusts are excluded from the analysis if the number of deaths or emergency admissions during the period.