A Study of Weekend and Off-hour Effect on Mortality in a Public Hospital in Malaysia
- Author:
Kian-Guan Lee
;
Indralingam Vaithilingam
- Publication Type:Journal Article
- Keywords:
Mortality, Weekends, Off hours, Weekend effect
- From:
The Medical Journal of Malaysia
2012;67(5):478-482
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Several studies have found higher in-hospital
mortality for admissions during weekend or off hours, known
as "weekend or off-hour effect". However, data for this on
Malaysian populations is limited. This study was conducted
to analyze the 3-year mortality trend in a secondary hospital and its relation to time and date of admission.
Methods: The clinical data of 126,627 patients admitted to
Taiping Hospital from 1st January 2008 to 31st December
2010 obtained via patient registry database of hospital was
analyzed. This study compared mortality during weekdays
with weekends, office hours (0800-1700) with off hours
(1701-0759), and subanalysis of office hours with evening
(1701-2259) or night hours (2300-0759), adjusted for age and gender.
Results: Although the overall staff-to-patient ratio is
improving, analyses showed a statistically significant
increased risk of mortality for those patients admitted
during weekends (OR = 1.22; 95% confidence interval [CI] =
1.14-1.31) or off hours in a weekday (OR = 1.67; 95% CI =
1.57-1.78). In the comparison between time of admission,
there was statistically significant increased risk of mortality for admissions during evening hours (OR = 1.44; 95% CI = 1.28-1.62) and night hours (OR = 1.92; 95% CI = 1.71-2.16). Diseases of cardiovascular and respiratory system remained the top two causes of death over the three years.
Conclusion: The risk of mortality is significantly higher as a result of “weekend or off-hour effect”. Recognition and intervention addressing these issues will have important implications for the healthcare system setting, hospital staffing and training, quality and timeliness of medical care delivery.
