This week’s New England Journal of Medicine has an interesting study about how differently emergencies are handled outside of normal working hours. The study looked at every patient in New Jersey hospitalized with his or her first heart attack between the years of 1987 and 2002. The authors separated the patients into two groups: those who were admitted on a Saturday or Sunday, and those admitted on a weekday. For each of the two groups the study looked at the fraction of these patients who received angioplasty or bypass surgery and the fraction of them who died within the year following their admission.
The patients admitted on the weekend were less likely to receive bypass surgery or angioplasty, and received these interventions longer after admission than the patients admitted on a weekday. The patients admitted on the weekend also had a 1% higher rate of mortality than those admitted during the week. This means that for every 100 patients admitted on the weekend there was 1 excess death over the number of deaths in 100 patients admitted during the week. Interestingly, the difference persisted even when the authors only considered hospitals that were supposedly equipped and staffed for emergency angioplasty around the clock.
Obviously these results have nothing to do with what patients should do. Don’t wait until Monday to get hospitalized if you get crushing chest pain on Saturday! But for hospital administrators this provides much to think about. For a disease as lethal as heart attacks, even a tiny improvement in the quality or timing of care might make a huge difference in the numbers of lives saved.
I was contacted recently by the owner of a website called The Walker Tracker. He had noticed my Pedometer Project and wanted my readers to know about his site. His website allows you to keep track of your steps, chart your progress, and connect with other walkers for encouragement and support. It’s free. Check it out.