A Study of Weekend and Off-hour Effect on Mortality in a Public Hospital in Malaysia

Kian-Guan Lee, Indralingam Vaithilingam
2012 Med J Malaysia   unpublished
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
more » ... try 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.