Dogs are out of control. Between 2009 and 2011 there was a 13% increase in the number of admissions to hospital due to dog attacks. A serious problem, dogs and their owners are out of control. Action must be taken! But what does this 13% actually mean? What is it 13% of? In 2009/10 there were 5,837 admissions to hospital due to dog attacks. In 2011/12 the number was 6,580. That's an increase in 13 % or 743 cases. Is this a big problem for the NHS or society in general? In order to work that out we need to know the number of hospital admissions. In 2009/10 there were 6,430,372. This means that dog attacks represent 1 in 10,000 admissions. So a 13% increase is an increase from 0.0118% to 0.103%. This means that we are dealing with very small numbers which are unlikely to be of much clinical significance. The same caution needs to be applied to other hospital statistics. Take for example the current debate about weekend working in the NHS. This has been fuelled by studies indicating that the risk of dying is greater if you are admitted to hospital at the weekend compared to a weekday. This is shown in a recent study which reported that the 30 day mortality was 16% greater if you are admitted at the weekend. But what does this mean? Is it for every 100 deaths during the week there are 116 at the weekend. We need to analyse the data further. 14.2 million people were admitted to hospital in 2009/10 and 187,337 died. This means that 1.3% of people admitted died. The rate of death if you were admitted at the weekend was 16% higher, in other words about 0.21%. This means that the chance of dying within 30 days of admission is 0.21% higher if you are admitted at the weekend compared to a weekday. Alternatively there is a 98% chance of survival if admitted on a weekday compared to a 97.68% chance if admitted at the weekend. Is this clinically significant? I would welcome your comments.
4 Comments
Cathy Cooke
7/6/2014 05:31:42 pm
On a population level I'd say not worth the cost. It would be unlikely that more money would be pumped into NHS to extend the service so it would be diverted from elsewhere, and the impact on mortality or morbidity of reduction or axing of other services would need to be assessed.
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anonymous
7/6/2014 05:33:05 pm
1. "Clinically significant"? What kind of statistical measurement is this?
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Richard Bogle
7/6/2014 06:46:26 pm
Yes of course that is true but that argument would lead us to a point where an infinite amount of resources might need to be spent even for a tiny benefit. That might be appropriate if there was no limit to spending on health.
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anonymous
8/6/2014 09:12:06 am
Thanks for response. Deaths are highly significant 'clinically'. Surely it should read 'statistically significant'.
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Dr Richard BogleThe opinions expressed in this blog are strictly those of the author and should not be construed as the opinion or policy of my employers nor recommendations for your care or anyone else's. Always seek professional guidance instead. Archives
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