Xiaojun Lin1, Jeremy C Green2, Hong Xian3, Miao Cai3, Julia Skrzypek4, Hongbing Tao5. 1. West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China. 2. The Mamdouha S. Bobst Center for Peace and Justice, Princeton University, Princeton, NJ, USA. 3. Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St Louis, MO, USA. 4. Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, St Louis, MO, USA. 5. Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China. hhbtao@hust.edu.cn.
Abstract
OBJECTIVES: To examine the effects of holiday and weekend admission on in-hospital mortality for patients with acute myocardial infarction (AMI) in China. METHODS: Patients with AMI in 31 tertiary hospitals in Shanxi, China from 2014 to 2017 were included (N = 54,968). Multivariable logistic regression models were used to examine the effects of holiday and weekend admission on in-hospital mortality. RESULTS: Compared to non-holiday and weekday admissions, holiday and weekend admissions, respectively, were associated with increases in risk-adjusted mortality rates. Chinese National Day was associated with an additional 10 deaths per 1000 admissions (95% confidence interval (CI): (0, 20))-a relative increase from baseline mortality of 64% (95% CI: (1%, 128%)). Sunday was associated with an additional 4 deaths per 1000 admissions (95% CI: (0, 7))-a relative increase from baseline mortality of 23% (95% CI: (3%, 45%)). We found no evidence of gender differences in holiday or weekend effects on mortality. CONCLUSIONS: Holiday and weekend admissions were associated with in-hospital AMI mortality. The admissions on Chinese National Day and Sunday contributed to the observed "holiday effect" and "weekend effect," respectively.
OBJECTIVES: To examine the effects of holiday and weekend admission on in-hospital mortality for patients with acute myocardial infarction (AMI) in China. METHODS:Patients with AMI in 31 tertiary hospitals in Shanxi, China from 2014 to 2017 were included (N = 54,968). Multivariable logistic regression models were used to examine the effects of holiday and weekend admission on in-hospital mortality. RESULTS: Compared to non-holiday and weekday admissions, holiday and weekend admissions, respectively, were associated with increases in risk-adjusted mortality rates. Chinese National Day was associated with an additional 10 deaths per 1000 admissions (95% confidence interval (CI): (0, 20))-a relative increase from baseline mortality of 64% (95% CI: (1%, 128%)). Sunday was associated with an additional 4 deaths per 1000 admissions (95% CI: (0, 7))-a relative increase from baseline mortality of 23% (95% CI: (3%, 45%)). We found no evidence of gender differences in holiday or weekend effects on mortality. CONCLUSIONS: Holiday and weekend admissions were associated with in-hospital AMI mortality. The admissions on Chinese National Day and Sunday contributed to the observed "holiday effect" and "weekend effect," respectively.