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Changes in mortalities and hospital admissions associated with holidays and respiratory illness: implications for medical services
Author(s) -
Keatinge W. R.,
Donaldson G. C.
Publication year - 2005
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2005.00533.x
Subject(s) - medicine , emergency medicine , respiratory illness , demography , emergency department , names of the days of the week , weekend effect , respiratory system , pediatrics , linguistics , philosophy , psychiatry , sociology
Rationale and objectives To see whether net mortalities increase during and after reductions in medical services, either at average weekends, or at Christmas when pressure from illness is unusually high. Methods (1) Paired t ‐tests to compare mean daily deaths and hospital admissions during and after weekends (Saturday–Tuesday) with means for the week, in south‐east England; (2) Linear regressions to see whether trends of daily deaths change when admissions are reduced at Christmas. Results Neither mean daily all‐cause, respiratory or ischaemic heart deaths exceeded weekly averages during weekends, or during Saturday–Monday or Saturday–Tuesday, despite falls in daily elective and daily emergency hospital admissions at weekends that averaged 61–72% and 14–22%, respectively. During 19–24 December, daily deaths were above annual means, respiratory deaths by 49% (29, 1–58), but elective admissions fell and although emergency admissions tended to rise, total admissions rose only for respiratory disease, and only by 33% (376, −47 to 799). On Christmas Day (25 December), even emergency admissions fell sharply below previous trends, respiratory emergency admissions by 18% ( P < 0.01). Respiratory deaths alone then immediately increased ( P < 0.01) above trend, by 5.9% (5.8 deaths/day) on 26 December and by 12.9% (12.9) on 27 December. Conclusions No adverse effect on mortality was apparent within 2 days from reduction in medical services at weekends. However, respiratory deaths accelerated sharply after reduction in elective and emergency admissions at Christmas, when rates of infection and mortality from respiratory disease were high. Implications for medical services during respiratory epidemics are discussed.