Key result
Weekend discharge was not associated with overall differences in 30-day readmission, mortality, or ED visits compared with weekday discharge, though 30-day readmission was higher in the USA.
Why the study?
While weekend admissions and operations have been associated with higher mortality, the association of weekend discharges with quality-of-care dimensions remained to be evaluated comprehensively.
Does weekend discharge increase 30-day readmission, mortality, ED visits, and 14-day follow-up visits compared to weekday discharge in hospitalized patients?
Meta-Analysis
Yes
Does weekend discharge increase 30-day readmission, mortality, ED visits, and 14-day follow-up visits compared to weekday discharge in hospitalized patients?
Weekend discharge is not associated with worse 30-day outcomes globally, but may be associated with higher 30-day readmission rates in the USA.
Reassures against restricting weekend discharges globally; leaves open whether US-specific.
PURPOSE: Hospital bed utility and length of stay affect the healthcare budget and quality of patient care. Prior studies already show admission and operation on weekends have higher mortality rates compared with weekdays, which has been identified as the 'weekend effect.' However, discharges on weekends are also linked with quality of care, and have been evaluated in the recent decade with different dimensions. This meta-analysis aims to discuss weekend discharges associated with 30-day readmission, 30-day mortality, 30-day emergency department visits and 14-day follow-up visits compared with weekday discharges. DATA SOURCES: PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov were searched from January 2000 to November 2019. STUDY SELECTION: Preferred reporting items for systematic reviews and meta-analyses guidelines were followed. Only studies published in English were reviewed. The random-effects model was applied to assess the effects of heterogeneity among the selected studies. DATA EXTRACTION: Year of publication, country, sample size, number of weekday/weekend discharges, 30-day readmission, 30-day mortality, 30-day ED visits and 14-day appointment follow-up rate. RESULTS OF DATA SYNTHESIS: There are 20 studies from seven countries, including 13 articles from America, in the present meta-analysis. There was no significant difference in odds ratio (OR) in 30-day readmission, 30-day mortality, 30-day ED visit, and 14-day follow-up between weekday and weekend. However, the OR for 30-day readmission was significantly higher among patients in the USA, including studies with high heterogeneity. CONCLUSION: In the USA, the 30-day readmission rate was higher in patients who had been discharged on the weekend compared with the weekday. However, interpretation should be cautious because of data limitation and high heterogeneity. Further intervention should be conducted to eliminate any healthcare inequality within the healthcare system and to improve the quality of patient care.
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Chiu et al. (2020) conducted a meta-analysis in Hospital discharge. Weekend discharge vs. Weekday discharge was evaluated on 30-day readmission, 30-day mortality, 30-day ED visits, and 14-day follow-up visits. Weekend discharge was not associated with overall differences in 30-day readmission, mortality, or ED visits compared with weekday discharge, though 30-day readmission was higher in the USA.
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