Another date with death

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A couple of years ago, back when weekend hospital staffing was big news, and the undefined “7-day NHS” was being used as a stick to beat doctors with, I wrote a blog post explaining why people admitted to hospitals on weekends might be more likely to die than those admitted on weekdays. I called it “A Date With Death“.

Hospital staffing certainly might be a factor here (and we’d all like hospitals to be better staffed, on any day of the week), but the most likely explanation is that people attending hospital on a weekend tend to be sicker, and sicker people are more likely to die. If you want more detail, I suggest you check out my original post.

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This week, a paper has been published in The Lancet which provides some data to support this common sense theory. Most previous papers tried to compare equally sick patients from weekdays and weekends, but the only way they had to measure this was using coding data, which is the data hospitals generate to show how much they should be paid. It’s a pretty low level way of assessing how ill a patient is. The Lancet paper adds in an extra set of clinical data – blood tests taken on admission. Once you add this information to the analysis, nearly half of the “excess weekend deaths” in Jeremy Hunt’s rousing speeches disappear.

Unfortunately, the news that the weekend effect is smaller than previously thought isn’t likely to trouble any government ministers, who probably knew their claims were shaky before they made them. It’s likely to pass by most of the health media too, particularly when everyone is focusing on cybercrime.

Nonetheless, for those of us who always suspected the “weekend effect” proved only that sicker patients are more likely to die, it’s nice to have an extra piece of evidence to point to. it’s a small blow for common sense against hyperbole.

If you want to read the Lancet paper, it can be found here.

 

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