Recently there has been a lot of talk about higher mortality over weekends. A British study, published in the Journal of Quality and Safety Care in June of 2010 concluded that there is a seven percent increase in mortality rate for patients who are admitted through the emergency room over the weekends as compared to patients who are admitted over weekdays. This was a large multi-center study conducted at 163 hospitals.
An other study published at Journal of American Society of Nephrology also concluded almost the same results. The study concludes that over the whole length of hospitalization, mortality risk is 7% higher for larger hospitals and 17% at community hospitals. As you can see this was found to be higher for small hospitals as compared to large hospitals.
Recently I attended a critical care committee meeting. There was a mortality report about our hospital, I was glad to hear that our mortality data for the hospital was not part of this mix.
However, I can see why this could happen. There are some factors which I can see contributes to these phenomena.
- Staffing issues,
- Reduced coverage among physicians
- Limited imaging studies.
- Problems with scheduling patients for GI procedures.
- Inability to perform cardiac stress tests.
- Out patient clinics are closed, so there is delay in diagnosing critical health issues.
- Hospital cultures in small hospitals are still managed by physicians who are not full time hospitalist.
(Maybe I am biased here as I am a hospitalist).
This studies should not be taken lightly, there may be a lot behind this. Do let me know if you have experienced the same problems.
Blog you later.
About the picture: If I am not wrong I think this work was called "Rumors"