Emergency medical admissions, deaths at weekends and the public holiday effect. Cohort study

Smith, S., Allan, A., Greenlaw, N. , Finlay, S. and Isles, C. (2013) Emergency medical admissions, deaths at weekends and the public holiday effect. Cohort study. Emergency Medicine Journal, 2014(31), pp. 30-34. (doi: 10.1136/emermed-2012-201881)

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Publisher's URL: http://dx.doi.org/10.1136/emermed-2012-201881

Abstract

<br>Objectives: To assess whether mortality of patients admitted on weekends and public holidays was higher in a district general hospital whose consultants are present more than 6 h per day on the acute medical unit with no other fixed clinical commitments.</br> <br>Design: Cohort study.</br> <br>Setting: Secondary care.</br> <br>Participants: All emergency medical admissions to Dumfries and Galloway Royal Infirmary between 1 January 2008 and 31 December 2010.</br> <br>Methods: We examined 7 and 30 day mortality for all weekend and for all public holiday admissions, using all weekday and non-public holiday admissions, respectively, as comparators. We adjusted mortality for age, gender, comorbidity, deprivation, diagnosis and year of admission.</br> <br>Results: 771 (3.8%) of 20 072 emergency admissions died within 7 days of admission and 1780 (8.9%) within 30 days. Adjusted weekend mortality in the all weekend versus all other days analysis was not significantly higher at 7 days (OR 1.10, 95% CI 0.92 to 1.31; p=0.312) or at 30 days (OR 1.07, 95% CI 0.94 to 1.21; p=0.322). By contrast, adjusted public holiday mortality in the all public holidays versus all other days analysis was 48% higher at 7 days (OR 1.48, 95% CI 1.12 to 1.95; p=0.006) and 27% higher at 30 days (OR 1.27, 95% CI 1.02 to 1.57; p=0.031). Interactions between the weekend variable and the public holiday variable were not statistically significant for mortality at either 7 or 30 days.</br> <br>Conclusions Patients admitted as emergencies to medicine on public holidays had significantly higher mortality at 7 and 30 days compared with patients admitted on other days of the week.</br>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Greenlaw, Miss Nicola
Authors: Smith, S., Allan, A., Greenlaw, N., Finlay, S., and Isles, C.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
Journal Name:Emergency Medicine Journal
Journal Abbr.:EMJ
Publisher:BMJ Publishing Group
ISSN:1472-0205
ISSN (Online):1472-0213
Published Online:23 January 2013

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