【台灣醒報╱記者莊瑞萌╱台北報導】
2011.05.23 05:39 pm
根據美國一所大學研究人員分析2003年到2007年，約有3千萬人到就診資料後發現，在周末進院治療的民眾，比其他時間進院接受治療的民眾，死亡率高出10%，研究人員認為這應該是與假日醫療人力較少有關。
美國麻州塔夫斯大學醫學院以5年期間，利用美國35州各大醫療院所共3千萬民眾就醫研究加以分析指出，若以進院時間觀察，在周末進院治療民眾其死亡率為2.7％，其他時間進院治療死亡率則為2.3％，研究人員理查迪表示，「2者出現差距的真正原因目前不明。」
本次研究分析超過2900萬位平均年齡46歲的民眾就醫資料，其中28.8％是在周末入院，在經過加總年紀、性別、種族、收入、病情狀況與其他因素後，周末入院的死亡率較其他時間入院者提高10.5％。而在26項檢查疾病中，其中15項與周末入院關聯特別明顯，包括慢性骨髓白血症（CML）、懷孕與分娩，至於心理疾病則較不受影響。
研究人員也發現，周末入院死亡率較高，可能是當時照護人力不足，較缺少有經驗醫師或是能進行的醫療檢查項目較少是主要原因。
不過，今年初一份針對美國賓州各醫療院所進行的調查發現，周末進院接受治療的民眾，反而可以得到比較好的治療服務。
本次研究結果刊登在《The Archives of Surgery》。
分析：周末進院 死亡率高出10%
版主: 版主021
Re: 分析：周末進院 死亡率高出10%
http://archsurg.ama-assn.org/cgi/conten ... /146/5/545
Mortality Rate After Nonelective Hospital Admission
Rocco Ricciardi, MD, MPH; Patricia L. Roberts, MD; Thomas E. Read, MD; Nancy N. Baxter, MD, PhD; Peter W. Marcello, MD; David J. Schoetz, MD
Arch Surg. 2011;146(5):545-551. doi:10.1001/archsurg.2011.106
Objective
We hypothesized that the mortality rate after nonelective hospital admission is higher during weekends than weekdays.
Design
Retrospective cohort analysis.
Setting
Patients admitted to hospitals in the Nationwide Inpatient Sample, a 20% sample of US community hospitals.
Patients
We identified all patients with a nonelective hospital admission from January 1, 2003, through December 31, 2007, in the Nationwide Inpatient Sample. Next, we abstracted vital status at discharge and calculated the Charlson comorbidity index score for all patients. We then compared odds of inpatient mortality after nonelective hospital admission during the weekend compared with weekdays, after adjusting for diagnosis, age, sex, race, income level, payer, comorbidity, and hospital characteristics.
Main Outcome Measure
Mortality rate.
Results
Discharge data were available for 29 991 621 patients with nonelective hospital admissions during the 5-year study period: 6 842 030 during weekends and 23 149 591 during weekdays.
Inpatient mortality was reported in 185 856 patients (2.7%) admitted for nonelective indications during weekends and 540 639 (2.3%) during weekdays (P < .001).
The regression revealed significantly higher mortality during weekends for 15 of 26 (57.7%) major diagnostic categories.
The weekend effect remained, and mortality was noted to be 10.5% higher during weekends (odds ratio, 1.10; 95% confidence interval, 1.10-1.11) compared with weekdays after adjusting for all other variables with the imputed data set.
Conclusions
These data demonstrate significantly worse outcomes after nonelective admission during the weekend compared with weekdays. Although the underlying mechanism of this finding is unknown, it is likely that factors such as differences in hospital staffing and services offered during the weekend compared with weekdays are causal and mutable.
Mortality Rate After Nonelective Hospital Admission
Rocco Ricciardi, MD, MPH; Patricia L. Roberts, MD; Thomas E. Read, MD; Nancy N. Baxter, MD, PhD; Peter W. Marcello, MD; David J. Schoetz, MD
Arch Surg. 2011;146(5):545-551. doi:10.1001/archsurg.2011.106
Objective
We hypothesized that the mortality rate after nonelective hospital admission is higher during weekends than weekdays.
Design
Retrospective cohort analysis.
Setting
Patients admitted to hospitals in the Nationwide Inpatient Sample, a 20% sample of US community hospitals.
Patients
We identified all patients with a nonelective hospital admission from January 1, 2003, through December 31, 2007, in the Nationwide Inpatient Sample. Next, we abstracted vital status at discharge and calculated the Charlson comorbidity index score for all patients. We then compared odds of inpatient mortality after nonelective hospital admission during the weekend compared with weekdays, after adjusting for diagnosis, age, sex, race, income level, payer, comorbidity, and hospital characteristics.
Main Outcome Measure
Mortality rate.
Results
Discharge data were available for 29 991 621 patients with nonelective hospital admissions during the 5-year study period: 6 842 030 during weekends and 23 149 591 during weekdays.
Inpatient mortality was reported in 185 856 patients (2.7%) admitted for nonelective indications during weekends and 540 639 (2.3%) during weekdays (P < .001).
The regression revealed significantly higher mortality during weekends for 15 of 26 (57.7%) major diagnostic categories.
The weekend effect remained, and mortality was noted to be 10.5% higher during weekends (odds ratio, 1.10; 95% confidence interval, 1.10-1.11) compared with weekdays after adjusting for all other variables with the imputed data set.
Conclusions
These data demonstrate significantly worse outcomes after nonelective admission during the weekend compared with weekdays. Although the underlying mechanism of this finding is unknown, it is likely that factors such as differences in hospital staffing and services offered during the weekend compared with weekdays are causal and mutable.
