Available online 4 August 2022, 102667

This paper explores whether breaks from surgical practice impact performance.

It uses variation in surgical practice driven by emergency hip fracture admissions.

Findings show that short breaks reduce 30-day mortality by around 6 percent.

Short breaks also affect the choice of surgery, suggesting less decision fatigue.

This paper explores whether breaks from surgical practice impact surgeons’ performance. Using a large panel of orthopaedic surgeons in England, I estimate the effect of surgeons’ breaks, measured by the number of days since their last surgery, on the health outcomes of emergency patients admitted after a hip fracture. To identify a causal effect, I implement a surgeon fixed effects model and exploit the quasi-exogenous variation in breaks from unanticipated emergency hip fracture admissions. Results show that short breaks of four to six days reduce 30-day mortality rates by around six percent relative to no breaks. Notably, short breaks also affect the type of surgery carried out, holding patient characteristics fixed. Overall, these findings show that the organisation of surgeons’ activity is a possible determinant of the quality of care provided.

J24

I10

I18

Patient outcomes

Surgeon

Workforce organisation

Skill depreciation

© 2022 Published by Elsevier B.V.