06-09-2016, 07:38
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#219
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cf.mega poster
Join Date: Apr 2004
Location: Northampton
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V6 STB
Posts: 8,120
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Re: Junior Doctors Prepare For First Full Walk-Out
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Overall, that amounts to an extra 11,000 deaths a year among those admitted between Fridays and Mondays.
Prof Sir Bruce Keogh, NHS medical director, one of the authors of the landmark study, said it revealed an “inconvenient truth” which could no longer be ignored, and required an overhaul in the way services are run.
The research by University Hospital Birmingham NHS Foundation Trusts and University College London, examined the effect of hospital admission day on death rates across NHS England hospitals for 2013-201
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A British study of more than 25,000 patients found those who took ill at the start of the weekend have death rates one fifth higher than those admitted during regular working hours.
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Researcher Dr Rahul Potluri, from Aston University, which led the ACALM study, said the differences were "extremely stark".
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There will be more neonatal deaths on a Thursday simply because of their being more births that day of the week, It is about the proportions.
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The most common day for giving birth was Thursday (15%; 206 732 births and 205 632 maternities), and the least common was Sunday (12%; 167 159 births and 159 132 maternities).
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Published in British Medical Journal.
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William L Palmer, honorary research fellow
A Bottle, senior lecturer
P Aylin, professor of epidemiology and public health
This study provides an evaluation of the “weekend effect” in obstetric care, covering a range of outcomes. The results would suggest approximately 770 perinatal deaths and 470 maternal infections per year above what might be expected if performance was consistent across women admitted, and babies born, on different days of the week.
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MacFarlane published a paper in 1978 that showed a seven day cycle in birth numbers across England (and Wales) and that perinatal mortality was higher among babies born at weekends.Similar studies in the 1970s found similar phenomena in other developed countries.The delivery of obstetric care has changed dramatically since that time; however, where the weekend effect has been evaluated, this has predominantly been based on mortality. In setting out key challenges in obstetric care—albeit in a broader, global context—a paper from the World Health Organization highlighted ineffective referral to, and inadequate availability of, 24 hour quality services to emergency obstetric care services
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Performance across four of the seven measures was significantly worse for women admitted, and babies born, at weekends. In particular, the perinatal mortality rate was 7.3 per 1000 babies delivered at weekends, 0.9 per 1000 higher than for weekdays (adjusted odds ratio 1.07, 95% confidence interval 1.02 to 1.13).
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Quote:
Dharmintra Pasupathy, MRC/RCOG clinical research fellow
Angela M Wood, lecturer
Jill P Pell, Henry Mechan professor of public health
Michael Fleming, statistician
Gordon C S Smith, professor of obstetrics and gynaecology
Objective To determine the effect of time and day of birth on the risk of neonatal death at term.Design Population based retrospective cohort study.
Setting Data from the linked Scottish morbidity records, Stillbirth and Infant Death Survey, and birth certificate database of live births in Scotland, 1985-2004.
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Conclusions Delivering an infant outside the normal working week was associated with an increased risk of neonatal death at term ascribed to intrapartum anoxia.
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And there's plenty more where they came from.
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