title: 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 weekends 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 inpatients 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 association 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 reflect a stable level of care or a generalized shortage of resources and staffing that subsumes any impact of weekly variations. Future research examining optimal staffing and resource levels is needed in such settings.
authors.affiliation: Massachusetts General Hospital, Center for Global Health, Department of Medicine, 100 Cambridge St, 15th Floor, Boston, Massachusetts 02114, USA Harvard Medical School, 25 Shattuck St, Boston, Massachusetts 02115, USA Indiana University School of Medicine, Department of Medicine, 545 Barnhill Drive, E317, Indianapolis, Indiana 46202, USA Moi University, College of Health Sciences, School of Medicine, Department of Medicine, P.O. Box 4606, 030100, Eldoret, Kenya gstone@partners.org.
authors.forename: Geren S
authors.initials: GS
authors.lastname: Stone
authors.affiliation: Moi Teaching and Referral Hospital, Nandi Road, P.O. Box 3, 30100, Eldoret, Kenya.
authors.forename: Wilson
authors.initials: W
authors.lastname: Aruasa
authors.affiliation: Moi Teaching and Referral Hospital, Nandi Road, P.O. Box 3, 30100, Eldoret, Kenya.
authors.forename: Titus
authors.initials: T
authors.lastname: Tarus
authors.affiliation: Moi Teaching and Referral Hospital, Nandi Road, P.O. Box 3, 30100, Eldoret, Kenya.
authors.forename: Mainard
authors.initials: M
authors.lastname: Shikanga
authors.affiliation: Moi Teaching and Referral Hospital, Nandi Road, P.O. Box 3, 30100, Eldoret, Kenya.
authors.forename: Benson
authors.initials: B
authors.lastname: Biwott
authors.affiliation: Moi Teaching and Referral Hospital, Nandi Road, P.O. Box 3, 30100, Eldoret, Kenya.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ngetich
authors.affiliation: Moi Teaching and Referral Hospital, Nandi Road, P.O. Box 3, 30100, Eldoret, Kenya.
authors.forename: Thomas
authors.initials: T
authors.lastname: Andale
authors.affiliation: Moi Teaching and Referral Hospital, Nandi Road, P.O. Box 3, 30100, Eldoret, Kenya.
authors.forename: Betsy
authors.initials: B
authors.lastname: Cheriro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003906:Developing Countries; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D055815:Young Adult
keywords: Africa; Health services; Hospital admissions; Hospital medicine