September 6th, 2012 at 10:00 am
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Beware “weekend effect” when taking elders to hospital

by Dorian Martin

Mom had a few trips to the hospital emergency room when she was a nursing home resident. Two times, she went by ambulance on a weekday, and we found she moved fairly smoothly through the admittance and treatment processes. Those experiences were in stark contrast to two other times when I accompanied her to the emergency room during a weekend.

On those weekend trips, we ended up stuck in the waiting room for more than five hours in one case and approximately six hours in the other before being called back for assessment and treatment. As I remember it, the average total time that Mom spent in the hospital from registration to discharge from the emergency room was approximately eight hours. Fortunately, she wasn’t facing any dire health issues when these trips happened. However, this type of wait can be difficult when elderly patients also suffer from dementia.

Why the difference in the wait? Perhaps more people needed care on the weekend. My other idea is that the hospitals didn’t adjust emergency room staffing levels to ensure that enough medical personnel were available on weekends.

“Weekend effect” in hospitals

Researchers have actually identified a weekend effect in hospitals. The U.S. Department of Health & Human Services notes that patients with various medical and surgical conditions may not see the best results when they are admitted after normal business hours or on the weekends — especially patients with heart attacks or strokes. A Johns Hopkins University report adds head traumas to the list of conditions where patients may be more likely to die if they are hospitalized over a weekend.

The latest John Hopkins study focuses on 38,675 patients between the ages of 65 and 89 who went to U.S. hospitals due to head traumas. Of these cases, slightly more than 25 percent arrived on weekends. The analysis found that weekend patients were 14 percent more likely to die from their injuries than those admitted on weekdays. And interestingly, the timing of admittance mattered the most, not the severity of the head injury or the number of other health conditions.

The researchers suggest two different reasons behind this finding. First of all, hospitals operate differently during the weekend since they have fewer experienced doctors and nurses available to see patients. Secondly, some hospitals may experience delays in getting specialists such as neurosurgeons to the hospital during a weekend.

Level 1 trauma centers as alternative

The U.S. Department of Health & Human Services reports that as of July 2011, Level 1 trauma centers avoid the weekend effect; these centers offer highly specialized staff at all times. If an elder suffers a serious injury or other life-threatening condition over the weekend, opt for a Level 1 trauma center if possible. If you are a caregiver, especially for a person with Alzheimer’s, you can do research on the availability of Level 1 trauma centers in your area, in case your loved one does need specialized care outside of normal working hours.

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