Should you avoid hospitals on weekends?

THE CLAIM:

If possible, avoid hospitals on weekends.

THE FACTS:

Many public services are less reliable on weekends. But does that apply to medicine as well?

In the past decade, studies have found that patients treated at hospitals on weekends have inferior outcomes when compared with those receiving care on weekdays. In some cases, researchers have found, that also can mean a higher death rate.

In one of the largest studies, published last year in The New England Journal of Medicine, scientists followed 231,164 heart attack patients admitted to New Jersey hospitals from 1987 to 2002. They found that those admitted on weekends were less likely to receive aggressive treatment, and had slightly higher death rates (12.9 percent, versus 12 percent for weekday patients).

Another extensive study, in The Annals of Surgery in November, looked at 188,212 patients who had non-emergency surgery. Those who had their operations on a Friday and spent the weekend recovering on a regular hospital floor were 17 percent more likely to die in the following 30 days than those who had their operations earlier in the week.

Some researchers say this so-called weekend effect has to do with less-aggressive care and hospital staffing changes. Others argue that weekend patients simply tend to be sicker, perhaps because they have delayed seeking care.

THE BOTTOM LINE:

There is growing evidence that hospital mortality rates are higher on weekends.