Examining the Weekend Effect and Its Relationship to Hospitals (2023)

If you walk into a mom-and-pop convenience store on a weekend, you may find that the service is slow. Weekends are downtimes for many businesses, and lots of retail stores are understaffed during lower-traffic periods like weekends, nights and holidays.

Examining the Weekend Effect and Its Relationship to Hospitals (1)

However, you may be surprised to learn that understaffing and diminished service during downtimes are experienced in hospitals, too. This phenomenon, called the Weekend Effect, is linked to increased death among patients admitted to the hospital. The Weekend Effect has also been linked to other serious repercussions, such as bleeding and infection.

Apparently, the Weekend Effect postpones time to life-saving treatment, and with emergency presentations in a hospital setting, a difference of a few minutes can be critical. This phenomenon may also be tied to a paucity of investigative (diagnostic) services available during the weekend as well as reduced access to specialized physicians, who are often “on-call” and not physically present in the hospitals on weekends.

Although the Weekend Effect has been documented in other countries — particularly in the United Kingdom where it has raised great concern — it has only been recently documented in the United States. Furthermore, although there are studies that fail to support its validity, a rapidly growing body of evidence seems to conclusively point to this phenomenon.

Let’s first take a look at some examples of the Weekend Effect as evidenced in the literature. Then, we’ll examine the greater significance of this phenomenon.

Weekend Effect and Stroke

With improvements in care, more people who experience strokes survive. Nevertheless, in a landmark 2015 study published in PLoS ONE, researchers found that the Weekend Effect is alive and well in the United Kingdom.

In this retrospective study, researchers examined mortality (i.e., death) among 37,888 people who were treated for stroke in a hospital setting between 2004 and 2012. When compared with weekday admissions to manage stroke, mortality at seven days following a weekend admission was 19 percent higher—even though there were 21 percent fewer admissions! Analyses of the data were adjusted for age, sex and 11 co-morbidities, or other chronic conditions, including malignancies, other circulatory disease problems, diabetes, and dementia.

Of note, in this study, mortality was lowest in the hospital with a dedicated stroke unit. Furthermore, mortality was higher for strokes with anunspecified cause than it was for cerebral infarction, wherein a blood clot interferes with blood flow to the brain.

The researchers also examined the effect of three other factors on stroke mortality: admissions during winter months, community versus large hospital admissions and greater distance between patient residence and the hospital itself (more than 20 kilometers). Although their findings were not statistically significant with respect to the influence of these other variables on mortality rates, the researchers suggest that these other three factors may still somehow play a role in the likelihood of patient survival after stroke.

(Video) 'Weekend effect' hospital risk found in Canadian study

The Weekend Effect has also been observed with respect to stroke mortality in the United States. In a research letter titled “’ Weekend Effect’ or ‘Saturday Effect’? An Analysis of Hospital Mortality for Patients With Ischemic Stroke in South Carolina,”researchers examined all acute ischemic stroke hospitalizations (20,187 cases) in South Carolina between 2012 and 2013. The researchers assessed the frequency of death in patients admitted for stroke according to the day of admission, and these crude mortality measures were adjusted for patient sex, age, race, year of admission, the season of admission, payer type, and Charlson Comorbidity Index (a measure that incorporates various other chronic conditions). Among this South Carolina patient population, stroke mortality was highest on Saturdays thus pinpointing the weekend effect to a specific day.

On a related note, results from this U.S. study suggest that stroke severity was greater during the weekends thus indicating a higher threshold for admission; patients admitted for stroke during the weekend were typically sicker than those admitted during the weekdays. This finding could confound results and explain some of the differences in mortality. In other words, because patients with stroke who were admitted over the weekend were sicker, they could be at increased risk of death.

Weekend Effect and Pediatric Surgery

In a 2014 study published in the Journal of Pediatrics, researchers from The Johns Hopkins University looked for the Weekend Effect among 439,457 U.S. pediatric surgeries that were performed between 1988 and 2010. These surgeries included abscess drainage, appendectomy, inguinal hernia repair, open fracture reduction with internal fixation (ORIF), placement of a surgical shunt, or revision of a surgical shunt.

The researchers found that mortality was higher among children who had weekend surgeries than it was among children who had weekday surgeries. Furthermore, children who received surgeries during the weekend were at higher risk for blood loss and blood transfusion, wound infections, wound rupture (wound dehiscence) and other adverse effects. As with other studies examining the Weekend Effect, these findings presented independently of other patient and hospital characteristics.

It should be noted that death secondary to pediatric surgery is rare in the United States and other developed countries. However, the results of this study do have clinical relevance because the Weekend Effect is still linked to a small number of deaths, and the preventable death of even one child is a profound loss to her family, friends, and community.

Weekend Effect and the Emergency Department

During weekends and other downtimes, the emergency department is the place where most hospitalized patients get admitted. In a 2013 study titled “Don't Get Sick on the Weekend: An Evaluation of the Weekend Effect on Mortality for Patients Visiting U.S. EDs,” researchers from the University of Michigan looked for evidence of the Weekend Effect among patients admitted to the hospital via the emergency department.

In this retrospective study, 4,225,973 cases representing 20 percent of the total admissions occurring by way of the emergency department during 2008 were analyzed. The Weekend Effect was observed in this sample, and more people who were admitted during the weekend died than those admitted on weekdays. This effect was consistently observed regardless of patient income, insurance status, hospital ownership (public or private), hospital teaching status and emergency room census. Moreover, the Weekend Effect was consistently evidenced among the top 10 most common diagnoses, such as stroke, heart attack, malignancy, and head injury, indicating that this phenomenon wasn’t specific to any one diagnosis.

What Medical Triage Is in a Hospital

What We Don’t Know

Although reduced weekend staffing is considered a general explanation for the Weekend Effect, we aren’t sure the exact causes of this phenomenon. For example, we don’t know whether these staffing issues pertain to nurses, specialists, physicians or some combination. We also don’t know whether increased hospital occupancy and overburden during the weekend played a role. Importantly, weekend shift changes during which care is transitioned may also contribute to this phenomenon.

Ultimately, the studies that currently examine the Weekend Effect are limited by their retrospective (not randomized-control) design, and further research needs to be done to suggest more concrete solutions. In the meantime, it’s probably a bad idea to indiscriminately cut or deny funding that affects staffing to hospitals.

(Video) Study shows higher hospital death risk on weekends

What Does All This Mean?

Let’s consider what the Weekend Effect means to individuals. In the studies cited, this phenomenon was observed among people being admitted to the hospital for acute and emergent presentations. Because these were emergency problems, the patients had no control over the time of the presentation and couldn’t choose whether to enter the hospital on a weekday or weekend.

Similarly, if you or a loved one experiences a medical emergency, admission needs to be swift regardless of the day. In other words, a heart attack that occurs on Saturday can’t wait for a Monday admission. Furthermore, please take heart that despite worries about the Weekend Effect, care provided by the vast majority of U.S. hospitals is good and follows strict clinical guidelines — preventable deaths are rare even on the weekends.

Instead of pertaining to the individual, the results of these studies hint at a greater issue faced by clinicians, administrators, advocates, and policymakers: how to reduce unnecessary deaths linked to discrepancies in the care provided during weekends and other downtimes. With the costs of health care burgeoning, there’s a lot of talk about cutting funding. However, we must ignore the rhetoric and gingerly consider cuts that affect staffing or quality of care in healthcare settings.

If a hospital is operating on the weekends, the services must be up to snuff. Hospitals can’t be cheap when it comes to resources and staffing. Furthermore, when shifts change and patient care is transferred, there should be no deprecation in services attributable to these transitions. Ultimately, if a hospital can’t provide the same quality of care during a weekend and a weekday, it’s questionable whether it should be providing weekend care at all. Specifically, studies have suggested that 24/7 access to specialized stroke centers, trauma systems, and pediatric intensive care units — settings in which access and staff availability are always consistent — have all demonstrated the ability to do away with the Weekend Effect.

The next time you hear a politician talking about cuts to healthcare, please consider that these cuts can translate into consequences that affect us all, like the Weekend Effect. The hospital isn’t a mom-and-pop convenience store where you can wait a bit longer for a cup of coffee or pack of peanuts without concerns for your health. A hospital is a place where time and resource availability are crucial and minutes count.


(Video) The Infamous Drug Trial That Shocked Britain | Real Stories Full-Length Medical Documentary

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  • Goldstein SD et al. “The ‘weekend effect’ in pediatric surgery — increased mortality for children undergoing urgent surgery during the weekend.” Journal of Pediatric Surgery. 2014; 49: 1087-1091.
  • Roberts SE, et al. “Mortality following Stroke, the Weekend Effect and Related Factors: Record Linkage Study.” PLoS ONE. 2015.
  • Sharp AL, Choi H and Hayward RA. “Don't get sick on the weekend: an evaluation of the weekend effect on mortality for patients visiting US EDs.” American Journal of Emergency Medicine. 2013; 31.
  • Shi, L, et al. “’Weekend Effect’ or ‘Saturday Effect’? An Analysis of Hospital Mortality for Patients With Ischemic Stroke in South Carolina.” Circulation. 2016; 134: 1510-1512.

Examining the Weekend Effect and Its Relationship to Hospitals (2)

By Naveed Saleh, MD, MS
Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news.

See Our Editorial Process

(Video) Why’s the Media, Health Experts Ignoring This Study?

Meet Our Medical Expert Board

Share Feedback

Was this page helpful?

Thanks for your feedback!

(Video) Study: Claims patients are more likely to die at weekends not true - BBC News

What is your feedback?


What is the weekend effect in hospitals? ›

What Is the Weekend Effect? Published studies have found that people checking into the hospital over the weekend are more likely to die within 30 days compared to those who are admitted on other days. The phenomenon has been dubbed “the weekend effect.”

What is the weekend effect phenomenon? ›

Plus, there is a phenomenon known as the “weekend effect” which suggests that patients admitted to hospital on Saturdays and Sundays have an increased risk of death.

What factors led to a dramatic decline in inpatient service utilization? ›

Three main factors have contributed to the decline in inpatient use of these procedures. Most important has been the shift from inpatient to outpatient settings, a result of new technologies and pressures from reimbursement mechanisms and utilization review policies.

What is the incentive under fee for service reimbursement? ›

Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care.

Why are hospitals slower on weekends? ›

If you've ever been to a hospital on a weekend or holiday and ended up waiting for hours to be discharged, there's a pretty simple explanation for that: There are fewer health professionals, lab technicians, and diagnosticians around. The thinner staffing doesn't generally affect urgent care.

Are the outcomes of hospital care different on weekends than weekdays? ›

Senior doctors also reviewed case notes covering 4,000 emergency admissions to 20 hospitals. They looked for errors, adverse events and assessed the overall quality of care. The research confirmed the 'weekend effect'. People admitted at weekends were 16% more likely to die than those who arrived in the week.

What is the concept of weekend? ›

: the end of the week : the period between the close of one work or school week and the start of the next. especially : Saturday and Sunday.

What happened over the weekend meaning? ›

Over the weekend means the same thing as during the weekend. It is used to talk about something that happened (or will happen) between Friday evening and Sunday evening.

Where did the concept of weekends come from? ›

The present-day concept of the "weekend" first arose in the industrial north of Britain in the early 19th century. The Amalgamated Clothing Workers of America union was the first to successfully demand a five-day work week in 1929.

What are the 3 main barriers for patients accessing hospital services? ›

Barriers to health care access
  • I. Problems with communication. ...
  • II. Problems with accessing help. ...
  • III. Problems with how health professionals relate to carers. ...
  • IV. Complexity of the health care system and lack of support for carers.
Aug 12, 2013

What are 4 factors that can lead to a challenging interaction with a patient? ›

fear, anxiety or distress. communication or language difficulties. unrealistic expectations. previous poor experience.

What are some factors that decrease access to health care? ›

Five key barriers to healthcare access in the United States
  • Insufficient insurance coverage. A lack of insurance often contributes to a lack of healthcare. ...
  • Healthcare staffing shortages. ...
  • Stigma and bias among the medical community. ...
  • Transportation and work-related barriers. ...
  • Patient language barriers.
Jul 27, 2022

What are the 3 components of reimbursement? ›

The three parts of reimbursement are coding, coverage, and payment. The code is a standard alphanumeric sequence that describes drugs, medical devices, and medical and surgical procedures and services.

How do doctors make money on Medicare patients? ›

Health care providers agreeing to accept Medicare assignment, or Medicare's approved amount as full payment, receive an 80 percent payment directly from Medicare, with patients paying the other 20 percent. Health care providers not accepting Medicare assignment, however, aren't paid directly by Medicare.

How do providers make money with fee-for-service? ›

Fee for service (FFS) is the most traditional payment model of healthcare. In this model, the healthcare providers and physicians are reimbursed based on the number of services they provide or their procedures. Payments in an FFS model are not bundled.

What days of the week are hospitals the busiest? ›

The magazine Reader's Digest quizzed emergency health workers about the quirks and peeves of the E.R. Here is some of what they had to say. “The busiest time starts around 6 p.m.; Mondays are the worst.

What day are hospitals most busy? ›

Holidays and Hospital Staff
  • Summer vacation.
  • Long weekends, e.g. Labor Day.
  • Major holidays like Christmas, Thanksgiving, and the 4th of July.

Why do hospitals make you wait so long? ›

Most emergencies happen after work hours, at night and on the weekends. When there aren't enough emergency staff present during these busy times, it leads to overcrowded waiting rooms and extreme delays.

Do hospitals discharge patients on weekends? ›

Yes, you can, but this is rarely the case. Most hospitals discharge patients during the weekdays. Research finds that people discharged from the hospital on the weekend are nearly 40 percent more likely to be back on Accident and Emergency within a week. Discharges from the hospital rarely take place over the weekend.

Why do doctors not work weekends? ›

First, doctors and dentists like being home with their families in the evening and on weekends. That's when their spouse/partner is home usually, as well as the kids, so they want to be home. They have enough patients to see during the day, so they make their income.

How can I know that I am getting the hospital with the best outcomes? ›

Talk to your doctor and other health care providers about the quality of care at hospitals. Some hospitals have more experience or better results treating certain conditions or performing certain procedures. Ask your doctor or health care provider which hospital has the best care and results for your condition.

Why is the weekend important? ›

Weekends offer a respite from the rat race. Not only does it reset your body, it also lowers your levels of stress, plus uplifts your mood. University of Rochester psychology professor Richard Ryan says on Life Science, “Workers, even those with interesting, high-status jobs, really are happier on the weekend…

What are the benefits of weekends? ›

Let's take a look at some of them:
  • Reduced stress and cardiac problems. Overwork is undeniably linked to stress, which leads to heart disease and even death. ...
  • Improved overall health. ...
  • Better sleep. ...
  • Disconnect and recharge. ...
  • Healthy weekend getaways. ...
  • Work better, feel better.
Dec 18, 2022

What is an example sentence for weekend? ›

The office is closed on weekends. I'm going away for the weekend. (US) We're going to the city on the weekend. = (Brit) We're going to the city at the weekend.

What do you do on weekends answers? ›

Answer 1:- Well the time at weekends I always spend time with my family as well with friends. I often watch a movie on weekends and also explore New restaurants in my home town. Answer 2:- I like hanging out with my friends, so on Saturdays and Sundays, I go out and spend some quality time the entire week.

What is the difference between weekend and weekends? ›

“Weekend” should be used when you're referring to the singular noun. “Weekends” should be used when you're referring to the plural. We use “weekend” when only one weekend is being spoken about and “weekends” when there is more than one.

Who came up with the idea of a weekend? ›

The weekend was invented in Greater Manchester 1843, when Salford Lyceum director and workers' rights activist Robert Lowes (also Sir Ian McKellen's Great Grandfather) campaigned to win workers the right to leisure time on Saturday afternoons.

When did the weekend become a thing? ›

The full 48 hours

The first change regarding the Jewish day of rest happened in America in 1908. A mill in New England allowed a two-day weekend so that its Jewish staff could observe the Sabbath. This was a hit with workers and led other industries nearby to introduce a five-day week too.

Who started weekends off? ›

A prominent factory owner — Henry Ford — also played a big role. Even though the federal government didn't begin to limit companies to a 40-hour workweek until 1938, Ford began to give his factory workers a two-day weekend in the early 1900s.

What are the 4 biggest challenges facing the healthcare sector? ›

Major Challenges Facing the Healthcare Industry Today
  • Cybersecurity Threats.
  • Telehealth Implementation.
  • Invoicing and Payments.
  • Price Transparency Mandate.
  • IT Healthcare Investments.
  • Patient Experience.
  • Effective Payment Models.
  • Healthcare Staffing Shortages.
May 24, 2022

What are the challenges faced by a hospital? ›

Top Hospital Quality Problems and How to Solve Them
  • Financial issues.
  • Government mandates.
  • Patient safety and quality care.
  • Staffing concerns.
  • Patient satisfaction.
  • Access to care.
  • Doctor-related issues.
  • Population health management.
Aug 26, 2022

What are 5 common causes of conflict in health care? ›

 Poor communication  Personality clash  Power differentials  Organisational problems  Incompatible work styles  Heavy workloads  Stress and fatigue  Unwillingness to assist The nursing staff are typically under a lot of time pressures, particularly the Ward Sister in this instance.

How do you answer how do you deal with a difficult patient? ›

How to deal with a difficult patient
  1. Create a suitable environment. ...
  2. Listen carefully. ...
  3. Give an empathetic response. ...
  4. Identify the cause of the problem. ...
  5. Ask for help. ...
  6. Repair the relationship. ...
  7. Maintain professionalism. ...
  8. Use appropriate nonverbal communication.
Oct 18, 2021

How do you deal with difficult patients in healthcare? ›

Here are six helpful tips for dealing with an angry patient in a professional and productive way.
  1. Stay Calm. ...
  2. Listen to Their Concerns. ...
  3. Find a Way to Connect With the Patient. ...
  4. Set Boundaries. ...
  5. Address Their Concerns. ...
  6. Don't Take It Personally.
Jun 15, 2022

What is the most common form of reimbursement in healthcare? ›

Fee-for-service (FFS) is the most common reimbursement structure and is exactly what it sounds like: providers bill a code for every service performed, including supplies.

What are the four main methods of reimbursement? ›

Here are the five most common methods in which hospitals are reimbursed:
  • Discount from Billed Charges. ...
  • Fee-for-Service. ...
  • Value-Based Reimbursement. ...
  • Bundled Payments. ...
  • Shared Savings.
Jun 29, 2017

What are the rules for reimbursement? ›

What Is An Expense Reimbursement?
  • The expense must be for deductible business expenses that are paid or incurred by an employee in the course of performing services for your organization.
  • The employee must be required to substantiate the amount, time, use, and business purpose of the reimbursed expenses.

Why do doctors not like Medicare? ›

Can Doctors Refuse Medicare? The short answer is "yes." Thanks to the federal program's low reimbursement rates, stringent rules, and grueling paperwork process, many doctors are refusing to accept Medicare's payment for services. Medicare typically pays doctors only 80% of what private health insurance pays.

Can you make too much money to be on Medicare? ›

Medicare plan options and costs are subject to change each year. There are no income limits to receive Medicare benefits. You may pay more for your premiums based on your level of income. If you have limited income, you might qualify for assistance in paying Medicare premiums.

Does Medicare pay 100 of medical bills? ›

Medicare doesn't typically cover 100% of your medical costs. Like most health insurance, Medicare generally comes with out-of-pocket costs including copayments, coinsurance, and deductibles. As you'll learn in this article, Original Medicare (Part A and Part B) costs can really add up.

Do patients get discharged on weekends? ›

Yes, you can, but this is rarely the case. Most hospitals discharge patients during the weekdays. Research finds that people discharged from the hospital on the weekend are nearly 40 percent more likely to be back on Accident and Emergency within a week. Discharges from the hospital rarely take place over the weekend.

What is the weekend effect ozone? ›

In simple terms, the ozone “weekday/weekend effect” is the occurrence of higher maximum surface ozone concentrations on average in many urban areas on weekends than on weekdays despite lower emissions of ozone precursors, volatile organic carbon compounds (VOCs) and nitrogen oxides (NOx), on weekends.

Can you refuse for someone to be discharged from hospital? ›

Can you refuse to be discharged from hospital? The courts have ruled that you cannot refuse to be discharged from hospital.

Can you be discharged from hospital at any time of day? ›

Talk to hospital staff if you're unhappy about your suggested discharge or transfer date. You have the right to discharge yourself from hospital at any time during your stay in hospital.

What happens if you walk out of a hospital without being discharged? ›

What happens if I try to leave the hospital on my own? The hospital administrator and nurses will urge you to stay because they have a duty to attempt to make you follow medical advice. If you insist on leaving, they will usually ask you to sign an against-medical-advice (AMA) form.


1. Jane Elliott's "Blue Eyes/Brown Eyes" Anti-Racism Exercise | The Oprah Winfrey Show | OWN
2. How childhood trauma affects health across a lifetime | Nadine Burke Harris
3. Studying the causes and effects of long COVID
(CBS Sunday Morning)
4. The surprising effects of pregnancy
5. Robby Soave: BOMBSHELL Study Reveals Masks Made Almost ZERO DIFFERENCE On Covid-19 Rates
(The Hill)
6. PBS NewsHour full episode, Feb. 14, 2023
(PBS NewsHour)
Top Articles
Latest Posts
Article information

Author: Lakeisha Bayer VM

Last Updated: 04/05/2023

Views: 5841

Rating: 4.9 / 5 (69 voted)

Reviews: 84% of readers found this page helpful

Author information

Name: Lakeisha Bayer VM

Birthday: 1997-10-17

Address: Suite 835 34136 Adrian Mountains, Floydton, UT 81036

Phone: +3571527672278

Job: Manufacturing Agent

Hobby: Skimboarding, Photography, Roller skating, Knife making, Paintball, Embroidery, Gunsmithing

Introduction: My name is Lakeisha Bayer VM, I am a brainy, kind, enchanting, healthy, lovely, clean, witty person who loves writing and wants to share my knowledge and understanding with you.