Further Confirmation of the “Weekend Effect”: The Global Comparators Project (BMJ Quality and Safety / BBC News / OHE / Health Economics / BMJ) | Dementia and Elderly Care News

Further Confirmation of the “Weekend Effect”: The Global Comparators Project (BMJ Quality and Safety / BBC News / OHE / Health Economics / BMJ)

Posted on July 12, 2015 by Dementia and Elderly Care News

Summary

Recent research indicates that the “weekend effect” is a systematic phenomenon in the quality of healthcare, which impacts upon mortality rates in hospital care internationally.

2,982,570 hospital records from 28 hospitals in England, Australia, the USA and the Netherlands during 2009–2012 were analysed. It was found that mortality outcomes vary with days of week in agreement with previous studies on the weekend effect.

Reference

Ruiz, M. Bottle, A. [and] Aylin, PP. (2015). The Global Comparators project: international comparison of 30-day in-hospital mortality by day of the week. BMJ Quality and Safety. July 6^th 2015. [Epub ahead of print].

There is a related editorial literature review on the “weekend effect” and suggested contributory factors:

Reference

Lilford, RJ. [and] Chen, YF. (2015). The ubiquitous weekend effect: moving past proving it exists to clarifying what causes it. BMJ Quality and Safety. June 29^th 2015. [Epub ahead of print].

Seven-day working has strong backing from the Department of Health:

Reference

Triggle, N. (2015). Doctors: Hunt willing to impose seven-day working. London: BBC Health News, July 16^th 2015.

Questioning the Economics of Seven Day Working as a Solution for Elevated Hospital Mortality at Weekends

“Using estimates produced by the NHS Seven Days a Week Forum, the annual cost of implementing seven-day hospital services is estimated to be between £1.07 billion and £1.43 billion. This exceeds the maximum amount that the NHS should spend to eradicate the weekend effect by a factor of 1.5 to 2.4, or between £339 million and £831million”.

Reference

Meacock, R. The Economics of Elevated Hospital Mortality at Weekends. [Online]: Office of Health Economics (OHE), July 14^th 2015.

This relates to:

Reference

Meacock, R. Doran, T. [and] Sutton, M. (2015). What are the Costs and Benefits of Providing Comprehensive Seven-day Services for Emergency Hospital Admissions? Health Economics. August 2015, Vol.24(8), pp.907-12. (Click here to view the PubMed abstract).

September 2015 Updates

A balanced discussion of the pros and cons from Nigel Edwards, Chief Executive of the Nuffield Trust:

Reference

Edwards, N. (2015). Seven-day working: the bigger picture. London: BBC Health News (Scrubbing Up), September 4^th 2015.

Questions of culture:

Reference

Triggle, N. (2015). Is there a Monday to Friday culture in the NHS?. London: BBC Health News, September 5^th 2015.

Further:

Reference

Triggle, N. (2015). NHS Weekend: Action demanded over death risk. London: BBC Health News, September 6^th 2015.

This relates to the latest statistical analysis of weekend admissions, survivorship models and discussion of potential implications for service design; which indicates:

Patients admitted at the weekend are in the highest category of risk of death.
Patients admitted on Saturday or Sunday have an increased likelihood of death.
There is an additional risk of death exists for admissions on Mondays and Fridays, extending the weekend effect into those two days.
An estimated 11 000 extra patients die per year within 30 days from admission occurring between Friday and Monday, compared with admission on the remaining days of the week (although the exact reasons remain unclear).

Reference

Freemantle, N. Ray, D. [and] McNulty, D. [et al] (2015). Increased mortality associated with weekend hospital admission: a case for expanded seven day services? BMJ. September 5^th 2015; 351: h4596.

Related editorial:

Reference

Aylin, P. (2015). Making sense of the evidence for the “weekend effect”. BMJ. September 5^th 2015; 351: h4652.

More (from Aston University):

Reference

Potluri, R. (2015). Is it time to re-appraise the weekend effect? Journal of the Royal Society of Medicine (JRSM). October 2015; 108(10): 382-3.

“Defensive” debate on the political interpretation of independent clinical evidence showing increased mortality in hospitals at weekends:

Reference

Jeremy Hunt ‘misrepresented weekend deaths data’. London: BBC Health News, October 22^nd 2015.

NHS Improving Quality: Seven Day Services Evidence Base

The NHS Improving Quality (NHS IQ) Seven Day Services Team surveyed health and social care leaders across the country to determine the main enablers and barriers to adopting 7 day working.

Reference

Seven day services: an evidence base of enablers for transformation. London: NHS Improving Quality, September 2015.

Earlier: Silly Season?

Commentary and analysis on a heated debate:

Reference

Pym, H. (2015). Seven-day NHS – claims and counter claims. London: BBC Health News, August 13^th 2015.

and on…

Reference

Hughes, D. (2015). Government ‘chasing headlines on NHS’, says doctors’ union. London: BBC Health News, August 15^th 2015.

Continuing through September 2015:

Reference

Pym, H. (2015). Junior doctors plan protests – trouble at hospital mill? London: BBC Health News, September 22^nd 2015.

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Dementia and Elderly Care News. Wolverhampton Medical Institute: WMI. (jh)

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This entry was posted in Community Care, Department of Health, For Doctors (mostly), For Nurses and Therapists (mostly), For Researchers (mostly), International, NHS, Nuffield Trust, Quick Insights, Standards, Statistics, UK, Universal Interest and tagged 7 Day Services, ACALM Study Unit: Aston Medical School, Acute Care, Acute Hospital Care, Acute Hospitals, Aston Medical School: Aston University, Aston University, Australia, Avoidable Mortality, BBC Health News, BMJ, BMJ Quality and Safety, British Medical Journal (BMJ), CLAHRCs: NIHR Collaborations for Leadership in Applied Health Research and Care, Costs and Benefits of Seven-Day Services for Emergency Hospital Admissions, Culture Change in the NHS, Day-of-the-Week Effect, Department of Cardiothoracic Surgery: University Hospitals Birmingham NHS Foundation Trust, Department of Health Sciences: University of York, Department of Informatics: University Hospitals Birmingham NHS Foundation Trust, Department of Primary Care and Population Health: University College London, Dr Fiona Godlee: Editor of the British Medical Journal, Dr Foster, Dr Foster Hospital Guide, Dr Foster Intelligence, Dr Foster Unit: Imperial College London, Dr Foster Unit: PCPH Imperial College London, Economics of Elevated Hospital Mortality at Weekends, Elective Procedures, Elevated Weekend Hospital Mortality, Emergency Admissions, Emergency Hospital Treatment, England, Farr Institute of Health Informatics Research: University College London, GC Database, Global Comparators (GC) Project, Global Comparators Project, Health Economics, Health Finance Managers Association (HFMA), Healthcare Financial Management Association, Healthcare Quality Improvement, HFMA: Healthcare Financial Management Association, High-Intensity Specialist-Led Acute Care (HiSLAC) Project, Hospital Mortality, Hospital Mortality Rates, Improving Patient Safety, Journal of the Royal Society of Medicine (JRSM), Manchester Centre for Health Economics: University of Manchester, Medical Director of NHS England: Professor Sir Bruce Keogh, Medical Directorate: NHS England, Monday to Friday Culture, Mortality, Mortality Associated With After Hours and Weekend Admissions, Mortality at the Weekend, Mortality by Day of the Week, Mortality Rates, Mortality Statistics, Myocardial Infarction Data Acquisition System (MIDAS), Netherlands, NHS Culture, NHS England, NHS Improving Quality (NHS IQ), NHS Improving Quality (NHS IQ) Seven Day Services Team, NHS Seven Days a Week Forum, Nigel Edwards: Nuffield Trust, NIHR CLAHRC West Midlands, NIHR Collaborations for Leadership in Applied Health Research and Care for Birmingham and the Black Country (NIHR CLAHRC-BBC), NIHR Health Services and Delivery Research Programme, Office of Health Economics (OHE), Orchestrated Intransigence, Patient Safety, Patient Safety Collaboratives, Patient Safety Improvement, Preventable Hospital Mortality, Professor Sir Bruce Keogh, Quality and Outcomes Research Unit: University Hospitals Birmingham NHS Foundation Trust, Quality Improvement, Quality of Care, Quality of Care at Weekends, QUORUM Metric for Comparing Hospital Death Rates, Seven Day Services Team: NHS Improving Quality (NHS IQ), Seven-Day Hospital Services, Seven-Day Working, Survivorship Models, UK National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRC) West Midlands, United States, University College London, University Hospitals Birmingham NHS Foundation Trust, University of Manchester, University of Warwick, University of Warwick Medical School, University of York, Urgent and Emergency Care, USA, Variations in Quality of Care, Warwick Centre for Applied Health Research and Delivery: University of Warwick, Warwick Medical School: University of Warwick, Weekend Effect, Weekend Hospitalisation and Additional Risk of Death, Weekend Mortality for Emergency Admissions, Weekend Working, Workforce Challenges in Emergency Medicine. Bookmark the permalink.

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