Silent night: retrospective database study assessing possibility of "weekend effect" in palliative care

Abstract

Objective: To compare the mortality of patients in a palliative care unit on working days with that on weekends and public holidays.

Design: Retrospective database study.

Setting: Palliative care unit in Germany.

Population: All admissions to palliative care unit between 1 January 1997 and 31 December 2008.

Main outcome measure: The impact of day type (working days or weekends and public holidays) on mortality was analysed using Poisson regression models.

Results: A total of 2565 admitted patients and 1325 deaths were recorded. Of the deaths, 448 (33.8%) occurred on weekends and public holidays. The mortality rate on weekends and public holidays was 18% higher than that on working days (mortality rate ratio 1.18, 95% confidence interval 1.05 to 1.32; P=0.005).

Conclusion: Patients in the palliative care unit were at higher risk of dying on weekends and public holidays. In the absence of a prospective study, the exact reasons for this correlation are unclear.