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Mortality rates higher for public holiday admissions

Guest post from Lawford Kidd , personal injury lawyers in Scotland regarding higher mortality rates for patients admitted to hospital during public holidays.

Patients admitted to hospital as an emergency during a public holiday have a much higher risk of dying that those admitted at other times, according to a recent research project, published in the Emergency Medicine Journal.

About the study

The study looked at all emergency medical admissions to Dumfries and Galloway Royal Infirmary that took place over a three year period from 1st January 2008 and 31st December 2010.

The researchers looked at the seven and 30 day mortality rates for all weekend and public holiday admissions, and compared those figures to admissions during the week and on non-public holiday days.

Study findings

The researchers found that:

  • 771 (3.8%) of the 20,072 emergency admissions died within seven days of admission and 1,780 (8.9%) within 30 days.
  • Comparing weekend admissions against all other days did not result in a significantly higher mortality at seven days or at 30 days.
  • By contrast, comparing all public holiday admissions against all other days showed mortality rates were 48% higher at seven days and 27% higher at 30 days.

The authors of the study concluded that patients admitted as medical emergencies on public holidays had significantly higher mortality at seven and 30 days compared with patients admitted on other days of the week.

Weekends are also a risky time

As well as the risks now found to exist for public holiday admissions, previous research has highlighted the higher risks faced by people admitted to hospital during the weekend.

Dr Foster, the health information company, assessed the levels of standards and services at English hospitals.

It found that patients are less likely to receive prompt treatment and are more likely to die if they are admitted to hospital at the weekend. In hospitals where more senior doctors are on sites, the chances of survival increase, however some A & E departments are in hospitals where few senior doctors are on site overnight or at weekends.

Measures of mortality

Dr Foster’s Hospital Guide, published in 2011, assessed hospitals against four key measures of mortality:

  • Hospital Standardised Mortality Ratio – a measure of in-hospital deaths.
  • Summary Hospital-level Mortality Indicator – a measure of mortality both in-hospital and for deaths outside of hospital within 30 days.
  • Deaths after Surgery – surgical patients who have died from a possible complication.
  • Deaths in low-risk conditions – deaths from conditions where patients would normally survive.

It found that only one NHS trust in England managed to achieve low mortality rates on every measure. One trust scored highly on every measure, and a further 19 scored highly against two of the measures.

“A safe NHS is an NHS that provides care 24/7,” Roger Taylor, Director of Research and co-founder of Dr Foster, commented at the time. “It is concerning that many of the issues raised in the first Hospital Guide remain problems ten years later: hospitals performing low volumes of surgery where high levels are needed to ensure good outcomes, and hospitals failing to meet the best standards of care despite many years of evidence of the impact this has on patients.”

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