Weekend admission to a psychiatric hospital is not associated with a higher risk of death compared to weekday admission, according to new King’s College London research.
But patients admitted at the weekend have shorter admissions and are more likely to be readmitted after 12 months, indicating that weekend patients may have ongoing, unresolved treatment needs.
Previous research on hospitals that provide physical healthcare has suggested an increased risk of death for patients admitted at the weekend, which is thought to be explained by varying availability of services on different days of the week. This new study, published online in The British Journal of Psychiatry, is the first to examine whether this association also exists for mental healthcare.
Researchers examined anonymised data from more than 45,000 admissions to a psychiatric hospital in the South London and Maudsley NHS Foundation Trust between 2006 and 2015. Of these, 7,303 were weekend admissions.
Being admitted to a psychiatric hospital at the weekend was not associated with an increased risk of death compared to weekday admission. However, patients admitted at the weekend spent around 21 fewer days in hospital compared to patients admitted during the week and had a 13% increased chance of readmission in the 12 months following discharge.
Dr Rashmi Patel from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London, and first author of the study, said: “Previous studies in physical healthcare have suggested an increased risk of death for patients admitted at the weekend, so we were relieved to find that this is not the case for weekend admission to a psychiatric hospital.
“On closer analysis we found that patients admitted to a psychiatric hospital at the weekend were younger than those admitted during the week, and therefore at lower risk of physical health problems which could increase their risk of death. However, after accounting for age and other demographic factors, we found that there was no statistically significant difference in risk of death between patients admitted at the weekend compared to during the week.
“We also found that weekend patients had shorter admissions and increased risk of readmission, which may suggest that they had ongoing, unresolved treatment needs related to a lack of community and social care services at the weekend. This highlights the need to consider not only the provision of mental health care services but also community and social care services across the week.
“Future research should focus on improving our understanding of other factors which affect people with mental illness at the weekend, such as access to community and social care, in order to better plan future provision of health and social care across the week.”
Dr Patel is supported by a Medical Research Council Clinical Research Training Fellowship.