Emergency readmissions are highest in patients discharged at weekends

BMJ 2015; 351 doi: (Published 30 September 2015) Cite this as: BMJ 2015;351:h5241
  1. Zosia Kmietowicz
  1. 1The BMJ

The chances of needing emergency readmission to hospital are higher among patients who are discharged over the weekend than those sent home during the week, experimental figures have shown.

Data from 2014 collected by the Health and Social Care Information Centre (HSCIC)1 showed that the rate of emergency readmissions within seven days of discharge increased over the week, from a low of 3.6% on Mondays and Tuesdays to 4.8% on Saturdays and 5.8% on Sundays.

But wide variation occurred across trusts. The highest readmission rate after a Sunday discharge was 72.7%, recorded by Coventry and Warwickshire Partnership NHS Trust, compared with a low of 5.1% among patients discharged from the trust on a Wednesday.

The next highest rate of readmissions among patients discharged on a Sunday was 66.2% at Kent Community Health NHS Trust, whose lowest readmission rate was among patients sent home on Mondays (15.4%). North East London NHS Foundation Trust showed similar variation, with a high of 63.6% readmissions among patients discharged on Sundays, compared with 5.1% of those discharged on Mondays.

The data collection was commissioned by the Department of Health to better understand hospital activity across a typical week. It used hospital episode statistics data from 16 525 110 hospital discharges during 2014, in which time 647 221 emergency readmissions occurred within seven days (3.9%). The proportions of discharges on Saturdays and Sundays (total 13.9%) were lower than on other days of the week.

In July 2015 the health secretary, Jeremy Hunt, outlined his commitment to seven day care, which he said was central to his plans to reduce avoidable deaths.2

The HSCIC report said that the differences in rates of emergency readmissions by day of discharge “should act as a signal to investigate why such variation exists and to investigate what drives the variation seen in the results.” Whether this variation was due to differences in quality of care or differences in the case mix of patients was not possible to say, the report added.

The analysis also found that people who were readmitted to hospital on Friday through Sunday stayed slightly longer than those readmitted on Monday through Thursday, which could be because of out-of-hospital care provision, case mix, and patient behaviour, the report said.

Ben Gummer, health minister, said, “These are experimental statistics; however, we are clear that patients should receive the same high quality, safe care, seven days a week.

“Many hospitals and out-of-hospital services are already working together to create a better service seven days a week, but we want to go further and faster to deliver safer services this parliament.”

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Cite this as: BMJ 2015;351:h5241


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