Emergency admissions death toll significantly higher on public holidays

January 23, 2013

Patients admitted to hospital as emergencies on public holidays are significantly more likely to die than those admitted on other days of the week - including weekends - indicates research published online in Emergency Medicine Journal.

International evidence suggests that the death rate among emergency admissions is around 10% higher at weekends than it is for other days of the week, which adds up to around 3000 extra deaths every year in England alone.

The authors wanted to find out if similar patterns were evident for patients admitted to hospital on public or bank holidays.

They therefore looked at seven and 30-day among patients admitted as emergencies to one district general hospital in Scotland between January 2008 and December 2010.

The hospital in question, which is the only district general hospital in the region, serves a population of 150,000 people, and admits 6700 patients as medical emergencies every year.

During the study period, just over 20,000 people were admitted as emergencies to the medical unit. Three-quarters (77%) were admitted during the week, with the remainder admitted at weekends.

Some 5.6% of these admissions occurred on public holidays, which, with the exception of 1st and 2nd January 2008, were part of a three or four day holiday period.

Patients admitted at weekends were slightly older, less likely to have cancer, and more likely to have a respiratory problem. Those admitted on public holidays were also more likely to have a respiratory problem. But otherwise there were no distinctive differences in the caseload.

In all, 771 patients (3.8%) died within seven days of admission, while 1780 (8.9%) died within 30 days. After taking account of factors likely to influence the results, death rates were only slightly higher at weekends.

But they were significantly higher for public holiday admissions - on weekdays and weekends - than for other days, the analysis showed.

Some 5.8% of patients died within seven days compared with 3.7% of those admitted on other days of the week, while 11.3% died within 30 days compared with 8.7% of those admitted at other times.

This means that patients admitted as on public holidays were 48% more likely to die within seven days and 27% more likely to do so within 30 days.

There were no differences in senior doctor staffing between normal weekends and weekdays at the hospital - a factor frequently cited to explain the differences in death rates between weekends and weekdays.

But public holidays are usually tagged on to a weekend, providing a three or four day holiday, resulting in what the authors refer to as a "cumulative effect."

"If we assume that patients with severe illnesses are no more likely to be admitted on any one day of the week than any other, then it becomes difficult to escape the view that a cumulative effect of lack of services and/or lack of doctors on public holidays must have a part to play in the higher public holiday mortality demonstrated in this study," they conclude.

Explore further: Study suggests poorer outcomes for patients with stroke hospitalized on weekends

More information: Emergency medical admissions, deaths at weekends and the public holiday effect. Cohort study, Online First, doi:10.1136/emermed-2012—2-1881

Related Stories

Study suggests poorer outcomes for patients with stroke hospitalized on weekends

July 9, 2012
A study of patients with stroke admitted to English National Health Service public hospitals suggests that patients who were hospitalized on weekends were less likely to receive urgent treatments and had worse outcomes, according ...

Weekend hospital stays prove more deadly than other times for older people with head trauma

August 7, 2012
(Medical Xpress) -- A Johns Hopkins review of more than 38,000 patient records finds that older adults who sustain substantial head trauma over a weekend are significantly more likely to die from their injuries than those ...

Recommended for you

High-fat diet in pregnancy can cause mental health problems in offspring

July 21, 2017
A high-fat diet not only creates health problems for expectant mothers, but new research in an animal model suggests it alters the development of the brain and endocrine system of their offspring and has a long-term impact ...

To combat teen smoking, health experts recommend R ratings for movies that depict tobacco use

July 21, 2017
Public health experts have an unusual suggestion for reducing teen smoking: Give just about any movie that depicts tobacco use an automatic R rating.

Opioids and obesity, not 'despair deaths,' raising mortality rates for white Americans

July 20, 2017
Drug-related deaths among middle-aged white men increased more than 25-fold between 1980 and 2014, with the bulk of that spike occurring since the mid-1990s when addictive prescription opioids became broadly available, according ...

Aging Americans enjoy longer life, better health when avoiding three risky behaviors

July 20, 2017
We've heard it before from our doctors and other health experts: Keep your weight down, don't smoke and cut back on the alcohol if you want to live longer.

Parents have critical role in preventing teen drinking

July 20, 2017
Fewer teenagers are drinking alcohol but more needs to be done to curb the drinking habits of Australian school students, based on the findings of the latest study by Adelaide researchers.

Fresh fish oil lowers diabetes risk in rat offspring

July 19, 2017
Fresh fish oil given to overweight pregnant rats prevented their offspring from developing a major diabetes risk factor, Auckland researchers have found.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.