Retrospective analysis of the national impact of industrial action by English junior doctors in 2016
Retrospective analysis of the national impact of industrial action by English junior doctors in 2016
复制标题
DOI：
10.1136/bmjopen-2017-019319
复制
发表时间：
2018-01-01
期刊：
影响因子：
2.9
通讯作者：
Aylin, Paul
中科院分区：
文献类型：
--
作者：
Furnivall, Daniel;Bottle, Alex;Aylin, Paul
目的研究2016年初英国初级医生的四次工业行动的影响。设计对住院病人护理的描述性回顾性研究，英国医院的事故和紧急情况（A&E）和门诊活动。设置英格兰所有医院。参与者所有参加A&E或门诊预约的患者或在3- 12个月内入院的患者。四次罢工的每一次都有一周的时间（1月12日，2月10日，3月9-10日和4月26-27日，不包括周末）。主要结果测量门诊预约和取消，A&E就诊，入院病人和所有住院死亡率在罢工日与病人活动在同一个工作日在罢工前和罢工后的几周比较。2700万门诊预约和340万A&E就诊在四个3周的分析。在四次罢工中，入院人数减少了31651人（-9.1%），急症室就诊人数减少了23895人（-6.8%），门诊预约人数减少了173462人（-6.0%）。此外，医院取消的门诊预约比预期多101109次（+ 52%）。4月26日至27日的罢工对正常服务的影响最大，紧急服务也受到影响。罢工期间死亡率并未明显增加。区域分析表明，在约克郡和亨伯地区的服务不成比例地受到更多的影响，由industrialaction.Conclusions初级医生在2016年初的工业行动造成了显着的影响，提供医疗保健的英国医院。我们还观察到这些罢工如何影响供应商的区域差异。
Objectives To examine the impacts of the four episodes of industrial action by English junior doctors in early 2016.Design Descriptive retrospective study of admitted patient care, accident and emergency (A&E) and outpatient activity in English hospitals.Setting All hospitals across England.Participants All patients who attended A&E or outpatient appointments or those who were admitted to hospital during the 3-week period surrounding each of the four strikes (12 January, 10 February, 9-10 March and 26-27 April, excluding weekends).Main outcome measures Raw numbers and percentage changes of outpatient appointments and cancellations, A&E visits, admitted patients and all inhospital mortality on strike days compared with patient activity on the same weekday in the weeks before and after the strikes.Results There were 3.4 million admissions, 27 million outpatient appointments and 3.4 million A&E attendances over the four 3-week periods analysed. Across the four strikes, there were 31 651 fewer admissions (-9.1%), 23 895 fewer A&E attendances (-6.8%) and 173 462 fewer outpatient appointments (-6.0%) than expected. Additionally, 101 109 more outpatient appointments were cancelled by hospitals than expected (+ 52%). The 26-27 April strike, where emergency services were also affected, showed the largest impacts on regular service. Mortality did not measurably increase on strike days. Regional analysis showed that services in the Yorkshire and the Humber region were disproportionately more affected by the industrial action.Conclusions Industrial action by junior doctors during early 2016 caused a significant impact on the provision of healthcare provided by English hospitals. We also observed regional variations in how these strikes affected providers.