Weekend effects on health outcomes and operational efficiency in emergency admissions to general medicine services of the Central Hospital of the Autonomous Province of Bolzano, Italy.

ABSTRACT

The possibility of higher death rates after admission to hospital during the weekend has been intensively investigated in North America and Northern Europe, while data are almost absent from Southern Europe and other WHOV regions. Increased death rates have not been uniformly confirmed. Differences in hospital care on weekends can vary depending on the reason for hospital admission, place and time. The aim was to verify whether weekend admission from the emergency department to internal medicine services is associated with parameters of operational efficiency in a Northern Italian hospital. A retrospective analysis was performed using hospital administration data of 3,594 admissions in 2016. A total of 287 patients (8.0%) had intensive care unit/IMCU transfers and 218 patients (6.1%) deceased in the hospital. Patients admitted on the weekend were similar to patients admitted during the week across age and gender, while weekend patients were more likely to be admitted on a "bad" day, defined as a day with a median number of admitted patients per day of >10 during the week and >9 on weekend. When adjusting for age and gender, patients admitted on weekend had significantly shorter length of stay compared to patients admitted during the week. In conclusion, emergency weekend admission to an internal medicine service was not associated with worse hospitalization-relevant outcomes in a regional hospital in Italy. Lower length-of-stay when emergency admission was on weekend is suggestive of lower disease severity of patients admitted to internal medicine services than on weekdays. If this represents higher risk of inappropriate hospital admission on weekends requires further study.