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Early in-hospital mortality following trainee doctors' first day at work

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Title: Early in-hospital mortality following trainee doctors' first day at work
Authors: Jen, MH
Bottle, A
Majeed, A
Bell, D
Aylin, P
Item Type: Journal Article
Abstract: Background There is a commonly held assumption that early August is an unsafe period to be admitted to hospital in England, as newly qualified doctors start work in NHS hospitals on the first Wednesday of August. We investigate whether in-hospital mortality is higher in the week following the first Wednesday in August than in the previous week. Methodology A retrospective study in England using administrative hospital admissions data. Two retrospective cohorts of all emergency patients admitted on the last Wednesday in July and the first Wednesday in August for 2000 to 2008, each followed up for one week. Principal Findings The odds of death for patients admitted on the first Wednesday in August was 6% higher (OR 1.06, 95% CI 1.00 to 1.15, p = 0.05) after controlling for year, gender, age, socio-economic deprivation and co-morbidity. When subdivided into medical, surgical and neoplasm admissions, medical admissions admitted on the first Wednesday in August had an 8% (OR 1.08, 95% CI 1.01 to 1.16, p = 0.03) higher odds of death. In 2007 and 2008, when the system for junior doctors' job applications changed, patients admitted on Wednesday August 1st had 8% higher adjusted odds of death than those admitted the previous Wednesday, but this was not statistically significant (OR 1.08, 95% CI 0.95 to 1.23, p = 0.24). Conclusions We found evidence that patients admitted on the first Wednesday in August have a higher early death rate in English hospitals compared with patients admitted on the previous Wednesday. This was higher for patients admitted with a medical primary diagnosis.
Issue Date: 23-Sep-2009
Date of Acceptance: 10-Aug-2009
URI: http://hdl.handle.net/10044/1/53110
DOI: https://dx.doi.org/10.1371/journal.pone.0007103
ISSN: 1932-6203
Publisher: Public Library of Science
Journal / Book Title: PLOS One
Volume: 4
Issue: 9
Copyright Statement: © 2009 Jen et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Science & Technology
Multidisciplinary Sciences
Science & Technology - Other Topics
Cohort Studies
Hospital Mortality
Outcome Assessment (Health Care)
Patient Admission
Personnel Staffing and Scheduling
Retrospective Studies
Risk Factors
MD Multidisciplinary
General Science & Technology
Publication Status: Published
Article Number: ARTN e7103
Appears in Collections:Department of Surgery and Cancer