Patients sent home during the December holiday season are at greater risk of death or a return to the hospital than those discharged at other times, an extensive research study has found.
The researchers said the reasons could include reduced hospital staffing, delays in booking appointments for follow-up care, and festive behavior — often marked by emotional stress, lack of sleep, and excessive eating and drinking. “These altered circumstances could destabilise an acute medical condition,” the researchers wrote in a summary of results published in the medical journal the BMJ.
They advised doctors and hospital staff to carefully plan discharges and to coordinate care throughout the holidays.
“Rather than rushing to get patients home, hospital clinicians should pay attention to discharge planning for this vulnerable group, ensuring optimal patient education, drug review, and follow-up care,” the researchers suggested. “Discharged patients, unlike unwanted gifts, should not be returned after the holidays.”
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They analyzed 217,305 cases of adults and children discharged from acute care hospitals in Ontario, Canada, during the two weeks at the end of the year and compared them with those discharged in late November and January.
Patients discharged during the holiday season were 39 percent less likely to have a follow-up appointment within seven days, perhaps to wait for the end of the holidays. What's more, they had a 16 percent greater risk of death or readmission to the hospital.
Per 100,000 patients, those released during the holidays had 2,999 fewer follow-up medical appointments, 26 more deaths, 188 more readmissions and 483 more visits to emergency rooms.
The results follow similar findings about the “weekend effect” on hospital care, in which patients admitted on Fridays or over the weekend are at greater risk of death or rehospitalization than those admitted on weekdays. “Delays in testing and procedures on weekends provide further evidence of real differences in weekend care,” researchers of the latest study wrote.