Several studies have identified a so called weekend effect for COPD patients who are admitted into the hospital on a weekend, resulting in an increase in the risk of dying.
There were several explanations for this, including:
- Shortage of staff
- Reduced availability of services
- Patients with severe exacerbations going directly to the ER
- Patients with milder symptoms waiting to see their doctors during the week
In a new study, researchers from the Lady Davis Institute at the Jewish General Hospital and McGill University, in Montreal, Quebec, Canada, used medical records to examine death rates in over 300,000 people over the age of 50 who were admitted to hospital with either COPD or pneumonia between 1990 and 2007
This new study analyzed the ‘weekend effect on COPD’ in a different way. This new study evaluated the risk by assessing whether patients who stayed in hospital over the weekend, even if they were admitted earlier in the week, also experienced an increased risk of death.
The results of this new approach to the weekend effect demonstrated that, regardless of when patients are admitted to hospital, the stay over the weekend increases the risk of death.
- Weekdays, the death rate was 80 per 10,000 per day.
- Friday, the death rate increased by 5%, (an increase of 4 deaths per 10,000).
- Saturday and Sunday the death rate increased by 7% (an increase of 5.6 deaths per 10,000 for each day)
This study indicates that the increase in the risk of death is due to a reduced quality of care, or reduced access to high quality care at the weekend, and actually begins with Friday.
To defend against this, regardless of the cause, be it low staffing – less qualified staff – indifference – reduced availability of services, enlist a friend or family member to act a your watchdog.
Your watchdog does not need to be “medically proficient”. Asking a few simple questions and observing the overall care is often enough. This person must be willing to speak up when needed – - one who is very observant and can be a bit pushy – - and if possible can “drop in to visit” at all different hours. The uncertainness of your watchdog’s arrival times tends to make a staff more aware, resulting in better care.
Data source: http://www.medicalnewstoday.com/releases/276780.php
Caregivers resources: http://www.copd-international.com/caregivers/