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

  • Silvia Angerer
  • Klaus Buttinger
  • Harald StummerEmail author
Original Paper


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.


Weekend Stroke Mortality 

JEL Classification

I11 I18 



The authors would like to thank the Upper Austrian Regional Health Insurance (OÖ GKK), especially Mr. Eckschlager and Mr. Schableger for providing the data and the helpful discussions.

Compliance with ethical standards

Conflict of interest

The authors declare they have no conflict of interest.

Supplementary material

10198_2019_1035_MOESM1_ESM.docx (24 kb)
Supplementary material 1 (DOCX 24 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.UMIT, University for Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Healthcare6060 Hall in TirolAustria
  2. 2.Salzkammergut KlinikumGmundenAustria
  3. 3.University Seeburg Castle, Institut für Gesundheitsmanagement und InnovationSeekirchen am WallerseeAustria

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