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New Study Suggests Hospital Care at Night Worse than Daytime Care

A new study published in The Journal of the American Medical Association reveals that the likelihood of patient survival after cardiac arrest (when the heart stops) in a hospital is significantly impacted by the time of day the attack occurs. This study follows earlier studies that demonstrated that patients fare worse during weekend care than they do during care received during the workweek for the same health problems.

In the recently-published study, almost 87,000 patients who suffered from cardiac arrest were studied at 507 hospitals during 7 years. Typically, when a patient’s heart stops, a team of medical professionals is called urgently to the patient’s bedside to begin rendering care from a “crash cart” that contains equipment such as a defibrillator and various drugs. As a practical matter, patients who suffer from a cardiac arrest are usually very sick and even at the best of times the rate of survival is fairly low (among the studied patients, approximately 20% of those who suffered a cardiac arrest during the day shift survived to the point of hospital discharge), but something about the night shift seems to make the chances of survival even worse. In the study, only 15% of those patients who suffered a cardiac arrest during the 11 p.m. – 7 a.m. shift survived long enough to be discharged from the hospital.

This study would suggest that the level of patient care received a night is subpar – either because the night shift workers are too tired to react as efficiently as the day shift workers or because there is less staff during the night hours such that they can’t check patients as often and react to problems as quickly or because the experience and skill level of night shift workers is lower than that of day shift workers. Whatever the explanation, it is reasonable to conclude that differences in care are not limited to cardiac arrest situations.

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