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Risk of Neonatal Death on Weekends vs Weekdays—Reply
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In Reply: Drs Malloy and Freeman dispute our premise that "deaths occurring on a particular day of the week spring from the cohort of births for that day of the week" and suggest that the risk of death is randomly distributed across the week. Because birth weight is a major risk factor for neonatal mortality, however, using a linked birth/death cohort file, our finding that the decrease in weekend deliveries was least pronounced in smaller infants strongly supports the notion that the risk of mortality is not randomly distributed across the week. We also disagree with their assertion that neonatal death "is a random event not necessarily related to the day of birth."
Indeed, their suggestion to obtain an estimate of weekend vs weekday mortality, under the premise that deaths are randomly distributed without regard to case mix, has often been used as a weekday vs weekend case-mix adjustment strategy. . . . [Full Text of this Article]
Jeffrey B. Gould, MD, MPH
Stanford University Medical Center
Palo Alto, Calif
Cheng Qin, MD, MPH;
Amy R. Marks, MPH
School of Public Health
University of California
Berkeley
Gilberto Chavez, MD, MPH
California Department of Health Services
Sacramento
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