Medical emergencies happen all the time, and surgeries can be scheduled any day of the week, too. But patients who go to the emergency room or schedule a surgery for Saturday or Sunday face a greater risk of dying within a month of their hospital stay.

According to a recent study published in the Journal BMJ Quality & Safety and reported on, the quality of care provided at hospitals on the weekend is not as good as the care offered Monday-Friday. This so-called “weekend effect” is caused by many things:

  • Reduced medical staff
  • Fewer specialists available
  • Less experienced doctors and nurses on duty
  • Lack of diagnostic services and test results

And while it’s unclear whether any particular factor contributes more to the death risk than any other, one thing is certain: substandard hospital care on the weekend leads to a greater chance of death, which can be the basis for a medical malpractice or hospital negligence claim.

Higher weekend risk

The BMJ study focused on deaths within 30 days of an ER admission or a planned or elective surgery. It examined data that was collected over a four-year period from nearly three million admissions at 28 urban hospitals in the United States, United Kingdom, Australia and the Netherlands.

For the U.S. hospitals that took part in the study, the risk of dying within 30 days of a Saturday or Sunday ER visit was 13 percent higher than during the work week. The risk of dying within 30 days after a weekend ER visit in the United Kingdom was 8 percent higher, and it was 20 percent greater at the Dutch hospitals. And in Australia, patients actually had a higher chance of dying within only a week of an ER visit.

When it comes to planned or elective surgeries, the study showed that patients admitted on a Saturday or Sunday had a higher probability of dying within 30 days of their operation. Interestingly, a “Friday effect” surfaced in the Dutch hospitals: if admitted for surgery on a Friday rather than a Monday, the risk of death was nearly 33 percent higher.

Contributing Factors

According to the study, the increased risk of death after a weekend ER admission or surgery can be attributed to several things:

  • More patients come to the ER on Saturday and Sunday, and they are often sicker and more unstable than weekday patients.
  • Hospitals are staffed with fewer and less experienced nurses and doctors on the weekend. Those who work the weekend shift are usually still in training, which means their decision-making skills are not at the same level as the doctors and nurses who work Monday-Friday.
  • Patients cannot always have diagnostic tests performed on the weekend, which means they cannot get any test results. For patients who need immediate care, a delayed test means a delayed diagnosis and delayed treatment, which leads to a greater chance of dying.

On a brighter note, the study revealed the weekend effect does not apply to all medical conditions. Death is more likely after a Saturday or Sunday hospital admission where the risk of dying is significant without immediate intervention, like a heart attack, pulmonary embolism, stroke, aneurysm and head trauma.

Kenneth T. Watkins

View all posts by
Kenneth T. Watkins

Kenneth T. Watkins is an accomplished trial attorney and Senior Shareholder with Sommers Schwartz. Over the course of his career, he has obtained numerous multimillion-dollar settlements. His achievements include one of the largest seven-digit medical malpractice cases in Macomb County in 2008, and his election to membership in the exclusive Million Dollar Verdict Club.