It is almost a holiday tradition this time of year for media outlets to trot out research showing how dangerous the festive season can be for your health.
One oft-cited statistic: that heart attacks spike on Christmas and New Year’s Day, owing to a combination of overeating, too much stress, ignoring niggling symptoms, and — perhaps most disturbingly — because hospitals go into holiday mode and provide second-rate services.
In the United States, the danger of this finding is usually cast as a Grinch-like effect: unwelcome, but largely harmless, and easily cured with good cheer.
In the United Kingdom, the topic is being dealt with far more soberly.
The idea that health services could be failing patients on holidays and weekends has been termed by UK editorialists as one of the largest political issues in recent memory.
It was core to a threatened strike by junior doctors in early December. And it was among the central reasons Prime Minister David Cameron’s Tory party was reelected this year.
Citing research suggesting up to 6,000 extra deaths occur in the United Kingdom because of differences of care on holidays and weekends, Cameron vowed to create a “truly seven-days-a-week” National Health Service by 2020 through making staffing levels constant every day of the year.
Ho ho, heart attack
Why are increased deaths on holidays and weekends whipping up a near-hysteria across the pond while in the United States — so far — they serve mostly as Christmas filler news?
One possibility is that the Brits may be getting ahead of themselves. While there is growing consensus among researchers that the “weekend effect” is real, there is very little agreement about what should be done to improve it.
“The big question is what causes the weekend effect,” said Paul Aylin, an epidemiologist from Imperial College London who has studied the phenomenon. “Is it senior staffing? Something do with junior doctors? Nursing? The availability of diagnostics? Or is it a combination of all of these?”
And the bigger question, Aylin added: “Will providing seven days of staffing make it go away?”
Another possibility for why UK doctors and politicians have taken the issue so seriously might have to do with the organization of health care itself. The commitment to identifying the problem that causes significant but not obvious harm to patients — and to tackling it at a national level — is easier to do in a centrally funded and managed system like the NHS.
Because of America’s patchwork of health providers and insurance coverage, “we end up working in silos” in the United States, said Dr. Anai Khotari, a surgery resident at Loyola University Chicago’s Stritch School of Medicine.
Khotari has identified several ways to ameliorate the weekend effect in surgical care — including by increasing nurse-to-bed ratios, introducing home health programs for discharged patients, and increasing electronic medical records. Despite publishing an article in October that outlines the path to improved outcomes, he expects change to come at a “glacial” pace.
In the meantime, Christmas and weekend deaths will continue to serve as clickbait and talk show fodder in the American news cycle. Unless more happens, it will likely be a seasonal tradition that continues for some time.
So, this New Year’s Eve, before washing down that second helping of pumpkin pie with an extra glass of champagne, maybe take a moment to consider: Is this the night I want to be doing a spot check on the quality of the American health care system?
