Abstract：
UNASSIGNED: In the healthcare system, in the last 30 years, the prognostically negative value of the so-called Weekend Effect (WE) has been internationally recognized. The WE is regarded as the increased risk a patient might incur when hospitalized during non-working days, of enduring severe complications in comparison to the same hospitalization that occur on working days. The aim of this study was to retrospectively verify whether, once a mistake was made during weekends or on holidays, in comparison to a mistake occurred on workdays, it subsequently implied a higher risk of complications, death included, in a statistical and medico-legal way.
UNASSIGNED: Three different evaluators independently examined a total of 378 medico-legal cases over a more than 20-year period. Eventual medical actions and omissions were labelled as \'mistake\' when the AJ claimed that at least one occurred; \'alleged mistake\' included the cases where the EW\'s report disagreed with the AJ\'s one; finally, \'no mistake\' when both the AJ and the EW agreed in their evaluations. During weekends there is a higher risk that a mistake occurs (OR=3.3, 95% CI=1.6;7.4; p-value<0.001) compared to weekdays. When death occurs, delayed diagnosis is the main cause (p=0.02), whereas a damaging action is more frequently claimed in general.
UNASSIGNED: We verified as actual the impact of the WE on patients\' outcome from a medico-legal point of view. The implications for an improvement of the several settings of the Italian NHS are various, and many are the consequences in the healthcare management.
UNASSIGNED: Three different evaluators independently examined a total of 378 medico-legal cases over a more than 20-year period. Eventual medical actions and omissions were labelled as \'mistake\' when the AJ claimed that at least one occurred; \'alleged mistake\' included the cases where the EW\'s report disagreed with the AJ\'s one; finally, \'no mistake\' when both the AJ and the EW agreed in their evaluations. During weekends there is a higher risk that a mistake occurs (OR=3.3, 95% CI=1.6;7.4; p-value<0.001) compared to weekdays. When death occurs, delayed diagnosis is the main cause (p=0.02), whereas a damaging action is more frequently claimed in general.
UNASSIGNED: We verified as actual the impact of the WE on patients\' outcome from a medico-legal point of view. The implications for an improvement of the several settings of the Italian NHS are various, and many are the consequences in the healthcare management.
摘要：
■在医疗保健系统中，在过去的30年里，所谓的周末效应(WE)的预测负值已得到国际认可。WE被认为是患者在非工作日住院时可能发生的风险增加，与工作日相同的住院相比，持续严重的并发症。这项研究的目的是回顾性地验证，一旦在周末或假期犯了错误，与工作日发生的错误相比，这意味着并发症的风险更高，包括死亡,以统计和医学法律的方式。
■三个不同的评估人员在超过20年的时间内独立检查了总共378起医学法律案件。当AJ声称至少发生了一项时，最终的医疗行为和遗漏被标记为“错误”；“涉嫌错误”包括EW的报告与AJ的报告不一致的情况；最后，当AJ和EW在评估中都同意时，\'没有错误\'。与工作日相比，周末发生错误的风险更高（OR=3.3，95％CI=1.6;7.4;p值<0.001）。当死亡发生时，延迟诊断是主要原因(p=0.02)，而通常情况下，破坏性行为更常见。
■我们从医学法律角度验证了WE对患者预后的影响。改善意大利NHS的几种设置的含义是多种多样的，许多是医疗保健管理的后果。
■三个不同的评估人员在超过20年的时间内独立检查了总共378起医学法律案件。当AJ声称至少发生了一项时，最终的医疗行为和遗漏被标记为“错误”；“涉嫌错误”包括EW的报告与AJ的报告不一致的情况；最后，当AJ和EW在评估中都同意时，\'没有错误\'。与工作日相比，周末发生错误的风险更高（OR=3.3，95％CI=1.6;7.4;p值<0.001）。当死亡发生时，延迟诊断是主要原因(p=0.02)，而通常情况下，破坏性行为更常见。
■我们从医学法律角度验证了WE对患者预后的影响。改善意大利NHS的几种设置的含义是多种多样的，许多是医疗保健管理的后果。
