Comparison of Case Fatality Rates for Acute Myocardial Infarction in Weekday vs Weekend Admissions in South Korea

Background. According to recent reports, reduced weekend staffing in hospitals may lead to a lower intensity of management of patients with acute conditions such as acute myocardial infarction (AMI). The present study evaluated differences in the case fatality rate of Korean patients admitted with AMI on weekdays vs those admitted on weekends. Methods and Results: The dataset was constructed from the Korea National Health Insurance Claims Database. The study population was 97,466 patients who were admitted to a hospital in Korea from 2003 to 2007 with AMI. Patients admitted on weekends had a higher 30-day fatality rate (20.1% vs 17.3%) than did those admitted on weekdays. Differences in the 30-day fatality rate were significant after adjusting for baseline characteristics and the severity of disease (odds ratio (OR), 1.21; 95% confidence interval (CI), 1.16-1.26). However, the 30-day fatality rate was insignificantly different after additional adjustment for medical or invasive management (OR 1.05; 95%CI 0.99-1.11). Conclusions: Differences in the case fatality rate of AMI patients admitted on weekdays and on weekends in Korea are caused by differences in the rate of performance of medical or invasive procedures. (Circ J 2010; 74: 496-502)