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Quantitative study - other
Excess mortality associated with weekend hospital admissions may be due to patient-level differences, rather than reduced staffing or services
  1. Pamela B de Cordova
  1. Rutgers School of Nursing, The State University of New Jersey, Newark, New Jersey, USA
  1. Correspondence to Dr Pamela B de Cordova, Rutgers School of Nursing, The State University of New Jersey, Newark, NJ 08901, USA; pd306{at}

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Commentary on: Walker AS, Mason A, Quan TP, et al. Mortality risks associated with emergency admissions during weekends and public holidays: an analysis of electronic health records. Lancet 2017;390:62–72.

Implications for practice and research

  • Practitioners should recognise that patients admitted during weekends more often display clinical characteristics that increase their mortality risk, compared with those admitted during the week.

  • Researchers who study the ‘weekend effect’ should consider severity of illness of emergency patients beyond the proxy measures found in administrative datasets.


The ‘weekend effect’ is defined as a higher mortality risk for patients admitted to the hospital on a weekend. This effect has been well documented in international literature and has gained attention among clinicians, researchers and the general public.1 In an attempt to explain why patients are at higher risk for death, researchers have focused on decreased resources including staffing and changes in service provision. However, differences in patient characteristics who are admitted on the weekend have not been …

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  • Funding Agency for Healthcare Research and Quality. Grant number: 1K08HS024339-01A1 Mentored Clinical Scientist Res.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.