CEO's Office, Picker Institute Europe, Oxford, Oxfordshire, UK.
BMJ Qual Saf. 2018 Jun;27(6):455-463. doi: 10.1136/bmjqs-2016-006349. Epub 2017 Sep 29.
To determine whether patients treated in hospital on the weekend report different experiences of care compared with those treated on weekdays.
This is a secondary analysis of the 2014 National Health Service (NHS) adult inpatient survey and accident and emergency (A&E) department surveys. Differences were tested using independent samples t-tests and multiple regression, adjusting for patient age group, sex, ethnicity, proxy response, NHS trust, route of admission (for the inpatient survey) and destination on discharge (for the A&E survey).
The inpatient survey included 154 NHS hospital trusts providing overnight care; the A&E survey 142 trusts with major emergency departments.
Three cohorts were analysed: patients attending A&E, admitted to hospital and discharged from hospital. From the inpatient survey's 59 083 responses, 10 382 were admitted and 11 542 discharged on weekends or public holidays. The A&E survey received 39 320 responses, including 11 542 (29.4%) who attended on the weekend or on public holidays. Weekday and weekend attendees' response rates were similar once demographic characteristics were accounted for.
For the A&E survey, six composite dimensions covered waiting times, doctors and nurse, care and treatment, cleanliness, information on discharge, and overall experiences. For the inpatient survey, three questions covered admissions and two dimensions covered information about discharge and about medicines.
People attending A&E on weekends were significantly more favourable about 'doctors and nurses' and 'care and treatment'. Inpatients admitted via A&E on a weekend were more positive about the information given to them in A&E than others. Other dimensions showed no differences between people treated on weekdays or on weekends.
Patients attending emergency departments or admitted to or discharged from an inpatient episode on weekends and public holidays report similar or more positive experiences of care to other patients after adjusting for patient characteristics.
确定在周末住院治疗的患者与在平日治疗的患者在护理体验方面是否存在差异。
这是对 2014 年国民保健服务（NHS）成人住院调查和急症（A&E）部门调查的二次分析。使用独立样本 t 检验和多元回归对差异进行了检验，调整了患者年龄组、性别、种族、代理响应、NHS 信托、入院途径（住院调查）和出院去向（A&E 调查）。
住院调查包括提供过夜护理的 154 家 NHS 医院信托；急症调查包括 142 家拥有主要急症部门的信托。
分析了三个队列：急症患者、住院患者和出院患者。从住院调查的 59083 份回复中，有 10382 份是在周末或公共假日入院，11542 份是在周末或公共假日出院。急症调查收到了 39320 份回复，其中 11542 份（29.4%）是在周末或公共假日就诊的。一旦考虑了人口统计学特征，周末和周末就诊者的回复率就相似了。
对于急症调查，六个综合维度涵盖了等待时间、医生和护士、护理和治疗、清洁度、出院信息以及整体体验。对于住院调查，三个问题涵盖了入院情况，两个维度涵盖了关于出院和用药的信息。
在周末就诊的急症患者对“医生和护士”和“护理和治疗”的评价更为有利。在周末通过急症入院的住院患者对在急症获得的信息比其他患者更为肯定。其他维度在平日和周末接受治疗的患者之间没有差异。
在调整了患者特征后，在周末和公共假日就诊急症部门或住院或出院的患者报告的护理体验与其他患者相似或更为积极。
