“春节效应”是否存在？内科住院患者在官方连续假期期间的医院死亡率：一项全国范围内基于人群的队列研究。
Does the 'Chinese New Year effect' exist? Hospital mortality in patients admitted to internal medicine departments during official consecutive holidays: a nationwide population-based cohort study.
机构信息
Department of Physical Medicine and Rehabilitation, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
出版信息
BMJ Open. 2019 Apr 20;9(4):e025762. doi: 10.1136/bmjopen-2018-025762.
OBJECTIVE
Our study aimed to compare the mortality risk among patients admitted to internal medicine departments during official consecutive holidays (using Chinese New Year holidays as an indicator) with that of weekend and weekday admissions.
DESIGN
Nationwide population-based cohort study.
SETTING
Taiwan's National Health Insurance Research Database.
PATIENTS
Patients admitted to internal medicine departments in acute care hospitals during January and February each year between 2001 and 2013 were identified. Admissions were categorised as: Chinese New Year holiday (n=10 779), weekend (n=35 870) or weekday admissions (n=143 529).
OUTCOME MEASURES
ORs for in-hospital mortality and 30-day mortality were calculated using multivariate logistic regression with adjustment for confounders.
RESULTS
Both in-hospital and 30-day mortality were significantly higher for patients admitted during the Chinese New Year holidays and on weekends compared with those admitted on weekdays. Chinese New Year holiday admissions had a 38% and 40% increased risk of in-hospital (OR=1.38, 95% CI 1.27 to 1.50, p<0.001) and 30-day (OR=1.40, 95% CI 1.31 to 1.50, p<0.001) mortality, respectively, compared with weekday admissions. Weekend admissions had a 17% and 19% increased risk of in-hospital (OR=1.17, 95% CI 1.10 to 1.23, p<0.001) and 30-day (OR=1.19, 95% CI 1.14 to 1.24, p<0.001) mortality, respectively, compared with weekday admissions. Analyses stratified by principal diagnosis revealed that the increase in in-hospital mortality risk was highest for patients admitted on Chinese New Year holidays with a diagnosis of ischaemic heart disease (OR=3.43, 95% CI 2.46 to 4.80, p<0.001).
CONCLUSIONS
The mortality risk was highest for patients admitted during Chinese New Year holidays, followed by weekend admissions, and then weekday admissions. Further studies are necessary to identify the underlying causes and develop strategies to improve outcomes for patients admitted during official consecutive holidays.
目的
本研究旨在比较内科患者在官方连续假期（以中国新年假期为指标）与周末和工作日入院的死亡率风险。
设计
全国性基于人群的队列研究。
设置
台湾全民健康保险研究数据库。
患者
确定 2001 年至 2013 年期间每年 1 月和 2 月在急症医院内科接受治疗的患者。入院分为：中国新年假期（n=10779）、周末（n=35870）或工作日入院（n=143529）。
结局测量
使用多变量逻辑回归计算住院死亡率和 30 天死亡率的 OR，并进行混杂因素调整。
结果
与工作日入院相比，中国新年假期和周末入院的患者住院和 30 天死亡率均显著升高。中国新年假期入院的住院（OR=1.38，95%CI 1.27 至 1.50，p<0.001）和 30 天（OR=1.40，95%CI 1.31 至 1.50，p<0.001）死亡率风险分别增加 38%和 40%。周末入院的住院（OR=1.17，95%CI 1.10 至 1.23，p<0.001）和 30 天（OR=1.19，95%CI 1.14 至 1.24，p<0.001）死亡率风险分别增加 17%和 19%。按主要诊断分层的分析显示，因缺血性心脏病入院的患者在春节假期住院死亡率风险增加最高（OR=3.43，95%CI 2.46 至 4.80，p<0.001）。
结论
中国新年假期期间入院的患者死亡率风险最高，其次是周末入院，然后是工作日入院。需要进一步研究以确定根本原因，并制定策略来改善官方连续假期期间入院患者的预后。
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