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Assessing the impact of a shadowing programme on in-hospital mortality following trainee doctors’ changeover

机译：评估遮蔽方案对实习医生转换后院内死亡率的影响

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To assess the impact on seven-day in-hospital mortality following the introduction in 2012 of a shadowing programme for new UK medical graduates requiring them to observe the doctor they are replacing for at least 4 days before starting work. Data on emergency admissions were derived from Hospital Episode Statistics between 2003 and 2019. A generalised estimating equation model was used to examine whether the introduction of the programme was associated with a change in mortality. There were 644,018 emergency admissions, of which 1.8% (7612) ended in death in hospital within a week following the admission. Throughout the study period, there was an annual increase in the number of emergency admissions during July and August, though in-hospital mortality rates declined. The generalised estimating equation analysis found no significant change in the odds of death within 7 days after admission for patients admitted on the first Wednesday in August compared with patients admitted on the last Wednesday in July (OR?=?1.03, 95% CI 0.94–1.13, p?=?0.53). Furthermore, there was no significant change observed for any clinical diagnosis category following the introduction of the shadowing programme. There was a rising trend in the number of emergency admissions over the study period, though mortality was decreasing. We found no significant association between the introduction of shadowing programme and in-hospital mortality; however, lack of power means that we cannot rule out a small effect on mortality. There are other outcomes that might have changed but were not examined in this study.
机译：2012年新英国医学毕业生的介绍后，评估七天内死亡率的影响，要求他们观察他们在开始工作前至少4天更换至少4天的医生。应急入学数据来自2003年至2019年间的医院剧集统计数据。广泛化估算方程模型用于检查该计划的引入是否与死亡率的变化有关。有644,018条应急录取，其中1.8％（7612）在入院后一周内的一周内终止于医院死亡。在整个研究期间，7月和八月的急救招生人数年增长率，尽管住院死亡率下降。广义估计方程分析发现，在八月的第一个星期三入院后7天内未发生死亡几率的重大变化与八月的患者在7月份（或？=？1.03,95％CI 0.94- 1.13，p？=？0.53）。此外，对于引入遮蔽程序后，任何临床诊断类别都没有显着变化。虽然死亡率下降，但研究时期的应急录取数量上升趋势上升。我们发现阴影计划和医院内死亡率之间没有重大关联;然而，缺乏权力意味着我们不能排除对死亡率的小效果。还有其他结果可能发生了变化，但在这项研究中没有检查过。

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