All patients admitted at the weekend for planned surgery in the four countries were more likely to die within 30 days than those admitted on other days of the week.
The researchers suggest possible reasons could relate to fewer and less experienced staff working on weekends, reduced access to test results and diagnostics, and longer waits for urgent treatment.
But in a linked editorial, Professor Richard Lilford and Dr Yen-Fu Chen of Warwick Medical School said the weekend effect was confirmed yet again and the focus now should be on its causes.
"Understanding the weekend effect is an extremely important task since it is large, at about 10 per cent in relative risk terms and 0.4 per cent in percentage point terms," they wrote.
"This amounts to about 160 additional deaths in a hospital with 40,000 discharges per year.
"But how much of the observed increase results from service failure?
"And here is the rub, for while a 0.4 percentage point represents a large, potentially scandalous, number of deaths, it is quite a small proportional change."
- AAP