Mortality Following Emergency Surgery – Hospital Level Failure

News Blog readers know that CLAHRC WM has a large interest in factors associated with hospital mortality – partly through a linked NIHR HS&DR grant on mortality following weekend admission, directed by Prof Julian Bion. A recent study of surgical mortality, based on the English Hospital Episode Statistics database, has again found an association between staffing levels (and other facilities) and surgical mortality.[1] The weekend effect was also greater where staffing levels were low. However, as pointed out in a previous post, staffing levels are a proxy for money, and vice-versa. That is to say, the lion’s share of a hospital’s budget goes on staffing; staff salaries are fixed nationally, and so there is not much that a hospital board can do if they are disadvantaged by the reimbursement formula or other unfavourable fixed costs. One thing the hospital board can do is to make sure that expenditure is kept under control so that draconian cuts are not needed downstream. If you want to take care of your patients, take care of your money.

— Richard Lilford, CLAHRC WM Director


  1. Ozdemir BA, et al. Mortality of emergency general surgical patients and associations with hospital structures and processes. Br J Anaesthesia. 2016: 116(1): 54-62.

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