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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
  1. Shu-Man Lin1,
  2. Jen-Hung Wang2,
  3. Liang-Kai Huang3,
  4. Huei-Kai Huang3
  1. 1 Department of Physical Medicine and Rehabilitation, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
  2. 2 Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
  3. 3 Department of Family Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
  1. Correspondence to Dr Liang-Kai Huang; luxtcu{at}gmail.com and Dr Huei-Kai Huang; drhkhuang{at}gmail.com

Abstract

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.

  • holiday
  • weekend effect
  • mortality
  • internal medicine
  • cohort study
  • Chinese New Year

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • L-KH and H-KH contributed equally.

  • Contributors The study was conceived and designed by S-ML, L-KH and H-KH. Data collection was conducted by J-HW and H-KH. Analysis and interpretation of data was conducted by J-HW and H-KH. The manuscript was drafted by S-ML, L-KH and H-KH, and critical revisions were provided by S-ML, J-HW, L-KH and H-KH. All authors approved the submission of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval This study was approved by the Institutional Review Board of the Hualien Tzu Chi Hospital (IRB105-113-C).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All relevant data are within the paper. No additional data are available.

  • Patient consent for publication Not required.

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