Patients discharged during the December holidays have an increased risk of death or readmission up to a month after being sent home
Patients discharged from hospital during the December holiday period are less likely to have early outpatient follow-up, and are at higher risk of death or readmission, according to a new study by researchers at ICES.
The study published today in the BMJ evaluated data on the outcomes of patients discharged during the December holiday period and compared them to patients discharged during two control periods in late November and January.
“Previous research has shown that patients admitted to hospital during off-hours are at increased risk of in-hospital mortality, and some studies have found that patients discharged from hospital on Fridays or weekends are at increased risk of readmission. But this is the first study to look at outcomes for patients discharged during the December holiday period,” says Dr. Lauren Lapointe-Shaw, a doctoral student at ICES and an internal medicine physician.
The results show that patients discharged during the December holiday period have an increased risk of death or readmission at seven days (13 per cent vs 12 per cent), 14 days (19 per cent vs 17 per cent) and 30 days (26 per cent vs 25 per cent) compared to patients released during the control periods.
Holiday-discharged patients were also less likely to have outpatient physician follow-up at seven days (36 per cent vs 48 per cent), or 14 days (60 per cent vs 69 per cent), after discharge compared to patients discharged during the control periods.
“Our results show that patients released during the December holiday had an increased risk of 30-day death or readmission compared to patients discharged at other times. The greatest risk increase was within seven days of hospital discharge, yet holiday-discharged patients were also less likely to have outpatient physician follow-up within one to two weeks of hospital discharge” says Lapointe-Shaw.
The researchers found that per 100,000 patients, there were 2,999 fewer 14-day follow-up appointments, 26 excess deaths, 188 excess hospitalizations and 483 excess emergency department visits attributable to December holiday discharge.
The December holiday, which always contains both Christmas and New Year’s days, was defined based on the two-week winter break described in the school year calendar in the province of Ontario.
Author block: Lauren Lapointe-Shaw, Peter C. Austin, Noah M. Ivers, Jin Luo, Donald A. Redelmeier and Chaim M. Bell.
The article “Death and readmissions after hospital discharge during the December holiday period: cohort study,” is published in the December 10th issue of the BMJ.
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