Weekend hospital mortality rates on the continent: better or worse than the UK?
Edmund Stubbs, 5 February 2015
For a number of years British researchers have been gathering statistical evidence of an increased possibility of mortality amongst patients admitted to hospitals at the weekend. Indeed, one study, with a sample size of 14 million, discovered a 16% increased probability of patient death outside of week days. The sheer size of this study makes its findings difficult to dispute.
What is open to debate however are the possible causes of this increase in mortality. Could it be due to understaffing at weekends, especially a lack of experienced clinical personnel, most particularly consultants? Or could it be simply that sicker people are admitted to hospital during the weekends generally being non-elective (emergency) cases?
Extensive research has shown that similar increased weekend mortality rates exist in countries such as the USA, Australia and Canada. However, uncertainty remains as to the situation in European, non-English speaking, countries.
A new report by Civitas aims to discover if sufficient research has been conducted to form a reliable understanding as to whether this ‘weekend’ increase in hospital mortality might occur in France and Germany to the same extent as it does in the UK.
The report further addresses whether differing factors in each country’s health care system might influence weekend mortality. For example, might higher levels of competition between providers (as is the case in Germany and France) influence staffing levels at weekends and therefore the quality of patient care? Or, conversely, if such competition amongst providers might influence a given care institution’s willingness to release mortality and staffing data?
Finally, the report considers whether social phenomena, such as strict data privacy laws in France, might form obstacles to the collection and study of clinical data (including staffing and mortality statistics) and thereby inhibit study.
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Edmund Stubbs, Healthcare Researcher
I suggest you look at the numbers who die in theatre or within a day or two of surgery. Perhaps the aftercare following surgery is less stringent at the weekend; perhaps more people are operated on late in the week with a resulting higher death rate.
It would also be worth trying to do an analysis of patients dumped on the NHS after treatment goes wrong in Britain’s private healthcare sector. Perhaps the privateers dump their failures on the NHS disproportionately towards the end of the week to clear the decks for the weekend.
The other problem with this sort of study is the difficulty of comparing countries. The record keeping of each country will be likely to differ in both type and especially quality.