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The weekend effect revisited: evidence from the Upper Austrian stroke registry

Author

Listed:
  • Silvia Angerer

    (UMIT, University for Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Healthcare)

  • Klaus Buttinger

    (UMIT, University for Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Healthcare
    Salzkammergut Klinikum)

  • Harald Stummer

    (UMIT, University for Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Healthcare
    University Seeburg Castle, Institut für Gesundheitsmanagement und Innovation)

Abstract

Empirical evidence on the so-called ‘weekend-effect’ on stroke mortality is mixed with some studies reporting significantly higher mortality for weekend admissions and others finding no difference. The aim of this paper is to enhance the evidence on the weekend-effect on stroke mortality using a rich stroke registry data set from Upper Austria and to discuss underlying reasons for the heterogeneity in results. Using logistic regressions and ordinary least squares regressions with hospital and year-fixed effects, the outcomes of weekend versus weekday admissions are compared for patients admitted to 16 hospitals in Upper Austria with transient ischemic attack (TIA), cerebral infarction or hemorrhage between 2007 and 2015. The primary outcomes include in-hospital mortality, 30-day and 90-day all-cause mortality as well as the length of hospital stay. In addition, we analyze differences in process-quality indicators between weekdays and weekends. Our results show that on weekends there are on average 25% fewer admissions than on weekdays with significantly higher in-hospital mortality. Adjusting for case-mix, the association between weekend admissions and mortality becomes null suggesting that the higher mortality on weekends is explained by heterogeneities in admissions rather than health-care quality.

Suggested Citation

  • Silvia Angerer & Klaus Buttinger & Harald Stummer, 2019. "The weekend effect revisited: evidence from the Upper Austrian stroke registry," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(5), pages 729-737, July.
    • Handle: RePEc:spr:eujhec:v:20:y:2019:i:5:d:10.1007_s10198-019-01035-4
    DOI: 10.1007/s10198-019-01035-4
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    References listed on IDEAS

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    1. Conrad Kobel & Josselin Thuilliez & Martine Bellanger & Karl-Peter Pfeiffer, 2011. "DRG systems and similar patient classification systems in Europe," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-00643049, HAL.
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    Cited by:

    1. Florian Bachner & Martin Zuba, 2022. "The weekend effect in stroke mortality: evidence from Austrian acute care hospitals," International Journal of Health Economics and Management, Springer, vol. 22(2), pages 205-236, June.

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    More about this item

    Keywords

    Weekend; Stroke; Mortality;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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