Study: Christmas the Deadliest Day of the Year

From The National Post:

A new U.S. analysis of mortality rates during different times of year found that people are more likely to die during the holidays — notably on Christmas and New Year’s Day — and researchers cannot explain the yearly spike.

After analyzing all official United States death certificates over the 25-year period between 1979 and 2004, a trio of sociologists identified an excess of 42,325 natural deaths — that is, above and beyond the normal seasonal winter increase — in the two weeks starting with Christmas.

In the article in the journal Social Science & Medicine, researchers David Phillips, Gwendolyn Barker and Kimberly Brewer report that mortality in general rises during the Christmas season.

Deaths in a hospital setting increase tremendously on the holidays themselves.

More people die in hospital emergency wards, or arrive dead on arrival, on Christmas, Boxing Day and New Year’s Day than on any other days of the year.

“It’s not trivial,” said Mr. Phillips, a professor of sociology at the University of California at San Diego. “We looked at all cause categories and, for nearly every one, we found an excess of deaths — particularly for people who are dying rapidly, like dead-on-arrival or dying in the emergency department.”

Read more:

For impatient patients, an urgent-care boomlet

Urban ER trends, reported by Crain’s New York Business–harbringer of trends in the rural ED?:

Urgent-care centers are springing up around Manhattan, a trend driven by emergency department doctors who see potential profit in steering New Yorkers clear of hospitals. Many impatient New Yorkers, they bet, would rather pay $150 to be treated within an hour than wait much longer than that in a hospital emergency room.

“In New York City—in Manhattan in particular—there’s a void in getting health care needs immediately serviced,” said Dr. Mark Melrose, who with business partner Dr. Neal Shipley opened Urgent Care Manhattan over the Thanksgiving weekend at 199 Amsterdam Ave., at West 69th Street. The board-certified emergency physicians honed their skills at Beth Israel Medical Center and New York-Presbyterian Hospital.

“Patients are fed up with long waits in the ER,” Dr. Shipley said. “We’re like the ‘easy’ button at Staples: You can see a board certified emergency physician with years of experience without an appointment in a city where you can’t even get your hair done without an appointment.”

Other emergency doctors are investing in the trend. These urgent-care centers aren’t affiliated with hospitals—although those also are proliferating—but are for-profit businesses run by entrepreneurial physicians.

Rural Physicians See Higher Average Compensation Than Those in Cities, Suburbs

From Becker’s Hospital Review:

The median cash compensation level for physicians in rural areas is higher than that of physicians in suburban and urban settings, according to data from Sullivan, Cotter and Associates.

Kim Mobley, a managing principal at SullivanCotter, says a few factors may contribute to the difference between urban and rural physicians. The difficulty rural hospitals face when recruiting specialists is the underlying issue beneath these differences. “The recruitment process is much more complex. In New York City, you might get 50 applications for a specialist position, but in North Dakota you might only get two,” says Ms. Mobley. With slow and difficult recruitment, it can take two to three years for some rural hospitals to hire the right physician. To some degree, rural hospitals may provide higher base compensation to simply attract physicians who may not want to move to rural settings.  

Also, rural areas do not typically have teaching hospitals. “Teaching hospitals tend to pay less because the faculty has a combination of clinical and academic work,” says Ms. Mobley. The data on which these figures are based includes teaching hospitals.

Many rural hospitals reflected in these figures may be located in health professional shortage areas, or areas medically underserved. Under Stark Law, hospitals within HPSAs may provide physicians with recruitment incentives. If physicians relocate their practice to the hospital’s geographic area, hospitals may offer relocating physicians incentives if they meet certain requirements. “This may include unique forms of payment, such as paying for loan forgiveness,” says Ms. Mobley. An emerging practice is to use retention bonuses to retain physicians in this competitive physician labor market.