Sources: BBC Health News; Dr. Foster Intelligence Hospital Guide 2001-2011; Journal of the American Medical Association
A British research company, Dr. Foster Intelligence, has studied hospitals in the UK from 2001 to 2011 and noticed that there was a “worrying” 10% spike in deaths compared with weekdays across 147 British Hospitals. The researchers concluded that some of those deaths could have been avoided with better staffing and access to services such as diagnostics. From the report, “Being admitted to hospital at weekends is risky. Patients are less likely to get treated promptly and more likely to die. The chances of survival are better in hospitals that have more senior doctors on site. But some hospitals with A&E departments have very few senior doctors in hospital at weekends or overnight.”
Dr Foster, which works closely with the Department of Health, said its findings needed to be investigated urgently. It looked at death rates using four measures – deaths in hospital, deaths in hospital and within 30 days of discharge, deaths linked to low-risk conditions and deaths after surgery. In total, 42 hospitals had higher than expected mortality rates on at least one measure, of which at least 22 were flagged up in two categories and two in three.
On the weekend performance, Roger Taylor, director of research at the group, said a shortage of senior doctors was at the heart of the problem. “It’s about having the more experienced staff in the hospital, looking after patients out of normal working hours.” Overall, 8.1% of those admitted at weekends died compared with 7.4% from Monday to Friday, once those having elective operations such as hip and knee replacements were discounted. Another notable finding of the report was, “Better care saves money. Hospitals that implement best practice in helping patients recover quickly from surgery achieve better outcomes for less money.” (Take that Tort Reformers).
Wondering what that has to do with care here in the US? Similar trends have been noticed in the same time period. In 2008, the Journal of the American Medical Association published findings that hospital care may be significantly worse on the weekends and at night than on weekdays. After reviewing the survival rates among patients across the country who experienced cardiac arrest during their hospital stays, researchers at Virginia Commonwealth University found that patient mortality rates were higher at certain times of day and on weekends, even when they factored in clinical variables like the patient’s condition and what the different heart rhythms were.
Dr. Mary Ann Peberdy and her colleagues looked at data on 86,748 adult in-hospital cardiac arrests occurring at 507 hospitals between 2000 and 2007, and found that the survival rate during weekdays and weekday evenings was 20.6 percent, while the survival rate on the weekend was only 17.4 percent and an even more disturbing 14.7 percent at night. That means patients were about 41% more likely to survive if they were treated during the day from Monday to Friday. And that wasn’t the first study to find a marked difference in hospital patients’ outcomes depending on when they are treated. A smaller report on heart attack survival rates at New Jersey hospitals was reported in the New England Journal of Medicine (2007) indicating similar trends for higher rates of death for patients admitted with acute MI (heart attacks) on weekends.
Posted by: Gayle R. Lewis, Eswquire