A new study from the University of Oxford has suggested that the 'weekend effect' – the idea that patients admitted to hospital at the weekend are more likely to die – is actually the result of "the way medical records are coded for data returns".
It's just one of many studies examining the phenomena and asking whether or not the weekend effect is real.
Do more people die at the weekend?
Health secretary Jeremy Hunt thinks yes. He recently argued the weekend effect was real, citing a study published in the British Medical Journal that he claimed showed "thousands" of extra deaths were caused because of the weekend effect. He used the article to argue against the recent strikes by junior doctors in the UK. "There is a weekend effect. Hospitals are applying a more stringent threshold to emergency admissions," he told a parliamentary select committee. "We don't offer the same standard of care at the weekend."
The BMJ study suggested that "admission at the weekend was associated with a significantly increased risk of in-hospital death compared with midweek admission", Hunt said.
A 2015 report from the government also suggested the weekend effect was real. Citing the same BMJ study, as well as several others, the report argued there was "significant evidence demonstrating the weekend effect."
But is it true?
Researchers from Oxford University say no. Peter Rothwell, who led the study, said that evidence for the weekend effect came from "unreliable" administrative data. "Most of the studies of the weekend effect have used hospital administrative data – diagnostic information extracted from medical records at some later data by non-clinical clerical staff," Rothwell said. "These coding data are fairly accurate for some things – surgical procedures or clearly specified chronic diseases, such as motor neuron disease – but is much less reliable for acute medical conditions such as stroke, infection or other vascular events." "So these acute admissions, which have the highest risk of death – and therefore 'drive' apparent weekend effects, are precisely the ones that are most likely to be miscoded." Rothwell went on to argue that differences in the data quality between weekday and weekend admissions could "completely skew any analysis of weekend effects".
Another study, published by the University of Manchester earlier this month, suggested more people died in hospitals at the weekend – but not because of inadequate care.
In a paper published in the *Journal of Health Services Research and Policy,*the researchers argued that the threshold for admission at the weekend was seven per cent fewer than for patients admitted during the weekend. This meant that people with acute conditions were more likely to be admitted than those experiencing less severe problems.
Because these patients were so ill, they were already more likely to die, the researchers concluded.
This article was originally published by WIRED UK
