“If you are admitted to hospital on a Sunday, you are 15% more likely to die than on a Wednesday”.
This is Jeremy Hunt- quoting a paper without atribution from the Journal of the Royal Society of Medicine, conducted in 2010 by Freemantle et al [1] amongst nearly 15 million admissions.
Here is the actual paper:
Here are the ACTUAL conclusions
1. Patients admitted on a Sunday were more likely to die over the next thirty days than a similar cohort of admissions on Wednesday- the ratio was 1.16 and the result significant, suggesting a true result of increased deaths by 16%
2. 94% of these ‘admissions’ were emergencies
3. 34% of deaths occurred within three days of admission
4. You are actually less likely to die if you are IN hospital on the weekend – the Sunday to Wednesday ratio here is 0.92, or 8% LESS likely. As the authors also conclude, this likely reflects the fact that high-risk, non-urgent procedures are performed during the week.
5. For elective (non-emergency) admissions, the ratio was 1.62 for Sunday to Wednesday, suggesting a 62% increased chance of death. This, as the authors conclude, is likely biased by the fact that high-risk elective patients are brought in early in general for exactly this reason, therefore this is unlikely to be significant.
6. Of 10 conditions specifically looked at, only 7 were found to show the same increased risk: sepsis, acute renal failure, cancer of the bronchus or lung, myocardial infarction, acute stroke, and congestive heart failure.
7. The authors also conclude: “7-day access to ALL ASPECTS of care” could improve such figures, but further ‘economic evaluation’ is required to ensure efficiency with ‘scant resources’ [para]
8. A further third of patients in this study died after discharge
So to summarise, you are 16% more likely to die, over the next thirty days, if you come into hospital on a Sunday- 30% will die within three days (Mon-Tues), and a further 30% will die after discharge. This only applies to emergency admissions, and a list of medical emergency conditions.
One major criticism, published by the authors themselves, is the fact that any conclusion completely ignores the reason for admission and the route of admission- there are no routine GP services on the weekend, and the impetus to admit on a weekend has to be higher than the week when most people would hold out for the GP unless they were very unwell. This immediately selects out a group of sicker patients than might routinely come in on a Wednesday.
