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dc.contributor.authorBriggs, Wteen
dc.contributor.authorGuevel, Blten
dc.contributor.authorMcCaskie, Andrewen
dc.contributor.authorMcDonnell, Stephenen
dc.date.accessioned2017-08-18T10:08:50Z
dc.date.available2017-08-18T10:08:50Z
dc.date.issued2018-01en
dc.identifier.issn0035-8843
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/266608
dc.description.abstractIntroduction The weekend effect is a perceived difference in outcome between medical care provided at the weekend when compared to that of a weekday. Clearly multifactorial, this effect remains incompletely understood and variable in different clinical contexts. In this study we analyse factors relevant to the weekend effect in elective lower-limb joint replacement at a large NHS multispecialty academic healthcare centre. Materials and Methods We reviewed the electronic medical records of 352 consecutive patients who received an elective primary hip or knee arthroplasty. Patient, clinical and time-related variables were extracted from the records. The data were anonymised, then processed using a combination of uni- and multivariate statistics. Results There is a significant association between the selected weekend effect outcome measure (postoperative length of stay) and patient age, American Society of Anesthesiologists classification, time to first postoperative physiotherapy and time to postoperative radiography but not day of the week of operation. Discussion We were not able to demonstrate a weekend effect in elective lower-limb joint replacement at our institution nor identify a factor that would require additional weekend clinical medical staffing. Rather, resource priorities would seem to include measures to optimise at-risk patients preoperatively and measures to reduce time to physiotherapy and radiography postoperatively. Conclusions Our findings imply that postoperative length of stay could be minimised by strategies relating to patient selection and access to postoperative services. We have also identified a powerful statistical methodology that could be applied to other service evaluations in different clinical contexts.
dc.format.mediumPrint-Electronicen
dc.languageengen
dc.language.isoenen
dc.publisherRCS Publications
dc.subjectHumansen
dc.subjectLength of Stayen
dc.subjectPerioperative Careen
dc.subjectArthroplasty, Replacement, Hipen
dc.subjectArthroplasty, Replacement, Kneeen
dc.subjectAnalysis of Varianceen
dc.subjectTime Factorsen
dc.subjectAgeden
dc.subjectMiddle Ageden
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectElective Surgical Proceduresen
dc.titleMulti- and univariate analyses of the weekend effect for elective lower-limb joint replacements.en
dc.typeArticle
prism.endingPage46
prism.issueIdentifier1en
prism.publicationDate2018en
prism.publicationNameAnnals of the Royal College of Surgeons of Englanden
prism.startingPage42
prism.volume100en
dc.identifier.doi10.17863/CAM.12714
dcterms.dateAccepted2017-05-21en
rioxxterms.versionofrecord10.1308/rcsann.2017.0116en
rioxxterms.versionAMen
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2018-01en
dc.contributor.orcidMcCaskie, Andrew [0000-0001-6476-0832]
dc.contributor.orcidMcDonnell, Stephen [0000-0002-3181-4192]
dc.identifier.eissn1478-7083
rioxxterms.typeJournal Article/Reviewen
rioxxterms.freetoread.startdate2018-08-03


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