Weekend specialist intensity and admission mortality in acute hospital trusts in England: a cross-sectional study

The Lancet

Volumn 388, Issue 10040, 2016, Pages 178-186

  Aldridge, Cassie ^a   Bion, Julian ^a   Boyal, Amunpreet ^b   Chen, Yen Fu ^c   Clancy, Mike ^d   Evans, Tim ^e   Girling, Alan ^a   Lord, Joanne ^f   Mannion, Russell ^a   Rees, Peter ^g   Roseveare, Chris ^h   Rudge, Gavin ^a   Sun, Jianxia ^b   Tarrant, Carolyn ⁱ   Temple, Mark ^b   Watson, Sam ^c   Lilford, Richard ^c  

^a UNIVERSITY OF BIRMINGHAM   (United Kingdom)

^b UNIVERSITY HOSPITALS BIRMINGHAM NHS FOUNDATION TRUST   (United Kingdom)

^c UNIVERSITY OF WARWICK   (United Kingdom)

^d UNIVERSITY HOSPITAL SOUTHAMPTON NHS FOUNDATION TRUST   (United Kingdom)

^e ROYAL BROMPTON AND HAREFIELD NHS FOUNDATION TRUST   (United Kingdom)

^f UNIVERSITY OF SOUTHAMPTON   (United Kingdom)

^g Academy of Medical Royal Colleges   (United Kingdom)

^h SOUTHERN HEALTH NHS FOUNDATION TRUST   (United Kingdom)

ⁱ UNIVERSITY OF LEICESTER   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CROSS-SECTIONAL STUDY; EMERGENCY WARD; ENGLAND; HOSPITAL ADMISSION; HOSPITAL MORTALITY; HUMAN; INTENSIVE CARE UNIT; MEDICAL SPECIALIST; MORTALITY RISK; MULTICENTER STUDY; PREVALENCE; PRIORITY JOURNAL; RISK ASSESSMENT; WARD; WORKLOAD; EMERGENCY; HEALTH CARE POLICY; HOSPITAL; HOSPITALIZATION; NATIONAL HEALTH SERVICE; ODDS RATIO; PERSONNEL MANAGEMENT; PHYSICIAN; QUESTIONNAIRE; SPECIALIZATION; STATISTICS AND NUMERICAL DATA; SUPPLY AND DISTRIBUTION; TIME FACTOR;

CROSS-SECTIONAL STUDIES; EMERGENCIES; ENGLAND; HEALTH POLICY; HOSPITAL MORTALITY; HOSPITALIZATION; HOSPITALS; HUMANS; ODDS RATIO; PERSONNEL STAFFING AND SCHEDULING; PHYSICIANS; SPECIALIZATION; STATE MEDICINE; SURVEYS AND QUESTIONNAIRES; TIME FACTORS;

EID: 84969916700     PISSN: 01406736     EISSN: 1474547X     Source Type: Journal    
DOI: 10.1016/S0140-6736(16)30442-1     Document Type: Article

References (35)

1. 1 Prime Minister's Press Office. The Queen's speech 2015. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/430149/QS_lobby_pack_FINAL_NEW_2.pdf, May 27, 2015 (accessed May 4, 2016).
2. 2 NHS England. Five year forward view. www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf, October, 2014 (accessed May 4, 2016).
3. 3 Morrissey, S, Blumenthal, D, Osborn, R, Curfman, GD, Malina, D, International Health Care Systems. N Engl J Med 372 (2015), 75–86.
4. 4 Bell, CM, Redelmeier, DA, Mortality among patients admitted to hospitals on weekends as compared with weekdays. N Engl J Med 345 (2001), 663–668.
5. 5 Lilford, RJ, Chen, YF, The ubiquitous weekend effect: moving past proving it exists to clarifying what causes it. BMJ Qual Saf 24 (2015), 480–482.
6. 6 Freemantle, N, Richardson, M, Wood, J, et al. Weekend hospitalization and additional risk of death: an analysis of inpatient data. J R Soc Med 105 (2012), 74–84.
7. 7 Hansard Online. Oral answers to questions: health. http://www.publications.parliament.uk/pa/cm201516/cmhansrd/cm151013/debtext/151013-0001.htm, Oct 13, 2015 (accessed May 4, 2016).
8. 8 Department of Health. 7-day NHS services: a factsheet. https://www.gov.uk/government/publications/7-day-nhs-services-a-factsheet, July, 2015 (accessed May 4, 2016).
9. 9 NHS England. Seven day hospital services. https://www.england.nhs.uk/ourwork/qual-clin-lead/7-day-week/#workstream (accessed May 4, 2016).
10. 10 Academy of Medical Royal Colleges. Seven day consultant present care. http://www.aomrc.org.uk/doc_view/9532-seven-day-consultant-present-care, December, 2012 (accessed May 4, 2016).
11. 11 Mikulich, O, Callaly, E, Bennett, K, O'Riordan, D, Silke, B, The increased mortality associated with a weekend emergency admission is due to increased illness severity and altered case-mix. Acute Med 10 (2011), 182–187.
12. 12 Freemantle, N, Ray, D, McNulty, D, et al. Increased mortality associated with weekend hospital admission: a case for expanded seven day services?. BMJ, 351, 2015, h4596.
13. 13 Morton, B, Nagaraja, S, Collins, A, Pennington, SH, Blakey, JD, A retrospective evaluation of critical care blood culture yield–do support services contribute to the “weekend effect”?. PLoS One, 10, 2015, e0141361.
14. 14 Bray, BD, Ayis, S, Campbell, J, et al. Associations between stroke mortality and weekend working by stroke specialist physicians and registered nurses: prospective multicentre cohort study. PLoS Med, 19, 2014, 11.
15. 15 Attenello, FJ, Wen, T, Cen, SY, et al. Incidence of “never events” among weekend admissions versus weekday admissions to US hospitals: national analysis. BMJ, 350, 2015, h1460.
16. 16 Buckley, D, Bulger, D, Trends and weekly and seasonal cycles in the rate of errors in the clinical management of hospitalized patients. Chronobiol Int 29 (2012), 947–954.
17. 17 McKinney, JS, Deng, Y, Kasner, SE, Kostis, JB, Myocardial Infarction Data Acquisition System (MIDAS 15) Study Group. Comprehensive stroke centers overcome the weekend versus weekday gap in stroke treatment and mortality. Stroke 42 (2011), 2403–2409.
18. 18 Bell, D, Lambourne, A, Percival, F, Laverty, AA, Ward, DK, Consultant input in acute medical admissions and patient outcomes in hospitals in England: a multivariate analysis. PLoS One, 8, 2013, e61476.
19. 19 Bray, BD, Ayis, S, Campbell, J, et al. Associations between the organisation of stroke services, process of care, and mortality in England: prospective cohort study. BMJ, 346, 2013, f2827.
20. 20 Ozdemir, BA, Sinha, S, Karthikesalingam, A, et al. Mortality of emergency general surgical patients and associations with hospital structures and processes. Br J Anaesth 116 (2016), 54–62.
21. 21 Meacock, R, Doran, T, Sutton, M, What are the costs and benefits of providing comprehensive seven-day services for emergency hospital admissions?. Health Econ 24 (2015), 907–912.
22. 22 NHS England. Bed availability and occupancy. https://www.england.nhs.uk/statistics/statistical-work-areas/bed-availability-and-occupancy/ (accessed May 4, 2016).
23. 23 Care Quality Commission. Inspection reports. http://www.cqc.org.uk/content/inspection-reports, 2016 (accessed May 4, 2016).
24. 24 Health & Social Care Information Centre. Indicator specification: summary hospital level mortality indicator. http://www.hscic.gov.uk/media/16110/Indicator-Specification-Summary-Hospital-level-Mortality-Indicator-methodology-updated/pdf/SHMI_specification.pdf, Aug 3, 2015 (accessed May 4, 2016).
25. 25 Ruiz, M, Bottle, A, Aylin, PP, The Global Comparators project: international comparison of 30-day in-hospital mortality by day of the week. BMJ Qual Saf 24 (2015), 492–504.
26. 26 Mohammed, MA, Sidhu, KS, Rudge, G, Stevens, AJ, Weekend admission to hospital has a higher risk of death in the elective setting than in the emergency setting: a retrospective database study of national health service hospitals in England. BMC Health Serv Res, 12, 2012, 87.
27. 27 Aylin, P, Alexandrescu, R, Jen, MH, Mayer, EK, Bottle, A, Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics. BMJ, 346, 2013, f2424.
28. 28 Palmer, WL, Vincent, CA, Dying for the weekend. A retrospective cohort study on the association between day of hospital presentation and the quality and safety of stroke care. Arch Neurol 69 (2012), 1296–1302.
29. 29 Klass, P, Death takes a weekend. N Engl J Med 372 (2015), 402–405.
30. 30 Turner, M, Barber, M, Dodds, H, Dennis, M, Langhorne, P, Macleod, MJ, Scottish Stroke Care Audit. Stroke patients admitted within normal working hours are more likely to achieve process standards and to have better outcomes. J Neurol Neurosurg Psychiatry, 2015 published online Aug 18. DOI:10.1136/jnnp-2015-311273.
31. 31 Aiken, LH, Sloane, DM, Bruyneel, L, et al. RN4CAST consortium. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet 383 (2014), 1824–1830.
32. 32 Shekelle, PG, Nurse-patient ratios as a patient safety strategy: a systematic review. Ann Intern Med 58 (2013), 404–409.
33. 33 Ghaferi, AA, Birkmeyer, JD, Dimick, JB, Hospital volume and failure to rescue with high-risk surgery. Med Care 49 (2011), 1076–1081.
34. 34 Ricciardi, R, Nelson, J, Francone, TD, et al. Do patient safety indicators explain increased weekend mortality?. J Surg Res 200 (2016), 164–170.
35. 35 Wu, TC, Chuah, SK, Chang, KC, et al. Outcome of holiday and nonholiday admission patients with acute peptic ulcer bleeding: a real-world report from southern Taiwan. Biomed Res Int, 2014, 2014, 906531.