The relationship of weekend admission and mortality on the public medical wards at a Kenyan referral hospital

Abstract

Background: Research has demonstrated disparities in the outcomes of patients admitted to hospital on week- ends in high-income countries. No published research has evaluated if any similar discrepancy exists in low- resource settings. Methods: To determine if any difference in mortality exists between weekend and weekday admissions on the public medical wards at a Kenyan referral hospital, we performed a retrospective observational study of inpati- ents over a 3-month study period. Results: During the study period, 261 (27.3%) of the 956 patients were admitted over the weekend. The mortality rates for patients admitted on weekends and weekdays did not differ with 156 (22.4%) of the 695 patients admitted on weekdays dying compared to 55 (21.1%) of the 261 patients admitted on weekends. After adjusting for age, insurance status, co-morbid illness, HIV status, employment, referral status and gender, still no associ- ation existed between weekend admission and mortality. Conclusions: Among adult patients on the medical wards, patients admitted on weekends had similar mortality rates to those admitted on weekdays. This similarity may re fl ect a stable level of care or a generalized shortage of resources and staf fi ng that subsumes any impact of weekly variations. Future research examining optimal staf fi ng and resource levels is needed in such settings.