Patients are much more likely to die if they are admitted to hospital on a bank holiday because there are fewer doctors on duty according to new research.Public holidays are usually tagged on to a weekend, providing a three or four day holiday, resulting in what the authors refer to as a “cumulative effect”.
The authors of the study Emergency medical admissions, deaths at weekends and the public holiday effect, published in Emergency Medicine Journal, wrote: “If we assume that patients with severe illnesses are no more likely to be admitted on any one day of the week than any other, then it becomes difficult to escape the view that a cumulative effect of lack of services and/or lack of doctors on public holidays must have a part to play in the higher public holiday mortality demonstrated in this study.”
According to the study, carried out at Dumfries Infirmary in south-west Scotland, patients admitted at weekends were slightly older, less likely to have cancer and more likely to have a respiratory problem. Those admitted on public holidays were also more likely to have a respiratory problem. But otherwise there were no distinctive differences in the caseload.
In all, 3.8 per cent died within seven days of admission, while 8.9 per cent died within 30 days. After taking account of factors likely to influence the results, death rates were only slightly higher at weekends.
But they were significantly higher for public holiday admissions – on weekdays and weekends – than for other days.
Some 5.8 per cent of patients died within seven days compared with 3.7 per cent of those admitted on other days of the week, while 11.3 per cent died within 30 days compared with 8.7 per cent of those admitted at other times.
This means that patients admitted as medical emergencies on public holidays were 48 per cent more likely to die within seven days and 27 per cent more likely to do so within 30 days.
There were no differences in senior doctor staffing between normal weekends and weekdays at the hospital – a factor frequently cited to explain the differences in death rates between weekends and weekdays.
Dr Sian Finlay, one of the researchers at Dumfries Infirmary: “Consultant physicians in Dumfries spend as much time on the acute medical unit during public holidays as they do on normal days and weekends.
“But it is also true that fewer consultants and junior doctors cover the other medical wards in holiday periods. It’s difficult to escape the view that higher mortality rates among patients admitted on public holidays reflects a cumulative lack of services and/or doctors during these three and four-day periods.”