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Record W7132974292

The care of hospital patients on weekends

2002· dissertation· W7132974292 on OpenAlexaboutno aff
Charles Michael Bell

Bibliographic record

VenueTSpace · 2002
Typedissertation
Language
FieldMedicine
TopicHospital Admissions and Outcomes
Canadian institutionsnot available
Fundersnot available
KeywordsMedical diagnosisStaffingAuditEmergency departmentPulmonary embolismMedical recordWeekend effectMortality rate
DOInot available

Abstract

fetched live from OpenAlex

Objective. We compared the quality of hospital care for patients on weekends compared to weekdays by evaluating mortality, procedural waiting times, staffing levels and potential predictors. Methods. We used primarily administrative databases analysis supplemented by a telephone survey, expert judgment, and professional association audits. All acute care hospitalizations resulting from an emergency department visit in Ontario, Canada were analyzed from 1988 to 1997 (n = 3,789,917). We examined both hospital discharge abstracts and billing records to the universal health insurance program for admission, in-hospital, and discharge information. We also conducted a telephone survey and an audit of professionally mandated claims by nurses. Experienced clinicians assessed the top one hundred causes of death with respect to the presence of seven theorized criteria. Results. Hospital mortality rates were significantly higher with admissions on a weekend rather than a weekday for patients with three prespecified diagnoses: ruptured abdominal aortic aneurysm (42% vs 36%, P < 0.001), acute epiglottitis (1.7% vs 0.3%, P = 0.04), and pulmonary embolism (13% vs 11%, P = 0.009). Of the top one hundred causes of death, 23 diagnoses (P < 0.001) showed a significantly higher mortality with weekend admission whereas no diagnosis showed a significantly lower mortality with weekend admission (P < 0.001). Clinical assessors were unable to identify common and specific characteristics to predict these 23 diagnoses (only diagnoses with a high in-hospital death rate had a P < 0.05). For seven selected urgent procedures, the mean wait from admission to procedural completion was longer on weekends compared to weekdays (3.9 days vs 3.6 days, P < 0.001). There is a relative decrease in both clinical (8–18%) and non-clinical staffing of (5–30%) on weekends compared to weekdays. Conclusion. More consistent weekend staffing may provide feasible, meaningful, and immediately available ways to improve health care.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.432
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.009
GPT teacher head0.309
Teacher spread0.300 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2002
Admission routes1
Has abstractyes

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