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Canine admissions: Is Christmas Eve the busiest day in practice?

Clinical Scenario

You are on the practice rota to be on call on Christmas Eve and you remember last year your colleague having a very busy Christmas Eve with multiple emergency calls and admitting lots of dogs to the hospital, claiming that it was their busiest day ever! You wonder if Christmas Eve is the busiest day of the year in small animal practice...

3-Part Question (PICO)

In [veterinary practices admitting dogs as emergencies] does [Christmas Eve compared to any other day of the year] have [a higher caseload]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

dog.mp. OR dogs.mp. OR canine.mp. OR canines.mp. OR canis.mp. OR exp Dogs/

AND

Admission.mp. OR admit$.mp. OR present$.mp. OR hospitalised.mp. OR hospitalized.mp. OR hospital$.mp. OR exp hospitals/ OR consultation.mp. OR consultations.mp. OR appointment.mp. OR appointments.mp.

AND

Noel.mp. OR Christmas Night.mp. OR yuletide.mp. OR night before Christmas.mp. OR December 24th.mp. OR 24th of December.mp. OR Gwiazdka.mp. OR la Nochebuena.mp. OR holiday.mp. OR exp holidays/ OR holidays.mp. OR day of week.mp. OR festive.mp.

CAB Abstracts 1910 to Present using the OVID interface

dog.mp. OR dogs.mp. OR canine.mp. OR canines.mp. OR canis.mp. OR exp dogs/

AND

Admission.mp. OR admit$.mp. OR present$.mp. OR hospitalised.mp. OR hospitalized.mp. OR hospital$.mp. OR consultation.mp. OR consultations.mp. OR appointment.mp. OR appointments.mp.

AND

Noel.mp. OR Christmas Night.mp. OR yuletide.mp. OR night before Christmas.mp. OR December 24th.mp. OR 24th of December.mp. OR Gwiazdka.mp. OR la Nochebuena.mp. OR holiday.mp. OR exp holidays/ OR holidays.mp. OR day of week.mp. OR festive.mp.

Search Outcome

MEDLINE

  • 23 papers found in MEDLINE search
  • 22 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from MEDLINE

CAB Abstracts

  • 42 papers found in CAB search
  • 41 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from CAB

Total relevant papers

1 relevant papers from both MEDLINE and CAB Abstracts

Summary of Evidence

Drobatz et al. (2009), USA

Title:

Association of holidays, full moon, Friday the 13th, day of week, time of day, day of week, and time of year on case distribution in an urban referral small animal emergency clinic.

Patient group:

Animals admitted to Emergency Service of the Mathew J. Ryan Veterinary Hospital of the University of Pennsylvania over a 15 year period (01/01/87- 31/12/02).

Study Type:

Retrospective cohort study

Outcomes:
  • Species admitted
  • Time and date of admission
  • Where the animal was transferred to afterwards for ongoing care OR whether the animal was discharged directly from the emergency service
  • Whether the admission fell on a holiday (New Year's Day, Easter, Memorial Day, Independence Day, Labor Day, Halloween, Thanksgiving, Christmas Eve, Christmas Day, New Year's Eve, Friday 13th)
  • The stage of the lunar cycle (ie. Whether a full moon was present)
Key Results:
  • 69% of cases seen were dogs and 31% were cats in 1987 (this did not change compared with 2002)
  • 71% of patients were discharged  directly from the emergency service (
  • 69% of dogs and 76% cats remained as emergency cases
  • Number of animals seen per quartile of the day increased throughout the day for Monday through to Friday, with the least number of animals seen between 12am and 6am (11% of animals) and the most  (38%) between 6pm and 12am
  • Busiest period was on weekend afternoons (12pm to 6pm= 36% of animals seen in the 24 hr period)
  • Most days had a 16-37% reduction in caseload relative to Sundays
  • The busiest holiday was Memorial day (72% increase in caseload)
  • New Year’s Day had a 50% increase in caseload and July 4th, Labor Day and Christmas 30-40% increase in caseload
  • Christmas Eve and New Year’s Eve had a 20% increase in caseload
Study Weaknesses:
  • Only one clinic, based in the USA, was used in the study and it was an Emergency clinic 
  • No sample size calculation given
  • Ethical approval not stated
Attachment:
No attachments.

Comments

This study is retrospective so may contain biases that would be overcome with a prospective study. As only one clinic was used, an emergency clinic, based in the USA, the results may not apply to practices in other countries or general practice.

Bottom line

The evidence suggests that Christmas Eve is busier than a normal day (20% busier, 95% confidence interval 10.64-32.87%, p<0.001), in emergency referral practice but that it is not the busiest day of the year.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

Drobatz KJ, Syring R, Reineke E, Meadows C, (2009). Association of holidays, full moon, Friday the 13th, day of week, time of day, day of week, and time of year on case distribution in an urban referral small animal emergency clinic. Journal of Veterinary Emergency and Critical Care 19 (5): 479–483

About this BET

First author:
Hannah Doit
Second author:
Rachel Dean
Institution:

CEVM, University of Nottingham

Search last performed:
2017-01-03 08:59:34
Original publication date:
2014-12-18 08:59:34
Last updated:
2017-01-03 08:59:34
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