Nurses moving a patient in a hospital corridor, hospital discharge

Nobody wants to be hospitalized during the holidays if at all possible. There are medical reasons to avoid hospital discharge during the winter holidays if you can.

What Is the Problem with Holiday Hospital Discharge?

Toronto researchers discovered that people hospitalized between Christmas and New Year’s Day are at greater risk than those hospitalized at other times of the year (BMJ, Dec. 10, 2018). The investigators found that people discharged from the hospital during this time frame were more likely than people discharged at other times to die or be re-admitted within a relatively short period of time.

Perhaps this is because they were less likely to connect promptly with a doctor for their follow-up visit. Ideally, people see their doctors within one or two weeks of hospital discharge. Those discharged around Christmas were 14 percent less likely to have a follow-up appointment within a week.

The differences in outcomes are not large, but they are significant.  In 100,000 patients, there are 26 more deaths and 188 more re-hospitalizations after hospital discharge during the December holidays. In addition, people discharged over the holidays made 483 more emergency room visits within the month.

Are There More Errors Over the Holidays?

We don’t know whether staffing changes or understaffing during December might have put patients  at risk of medical errors. The researchers did not provide that information in their report. They note, however, that holiday hospital discharge mostly affected a group of patients that would be judged upon admission to be at lower risk of complications.

In this regard, they write:

“One example of how this could occur would be if in a setting of reduced resources over the holidays, clinicians prioritise higher risk patients for more thorough discharge planning.”

In closing, they observe:

“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. Discharged patients, unlike unwanted gifts, should not be returned after the holidays.”

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  1. Karen

    My late daughter was treated horribly by the doctors in SW Oregon. Once they did not allow her a bed after going to the ER on the eve of thanksgiving. She and her boyfriend went to the store to try to find something that she could eat and she collapsed in the store. Ambulance came to get her and she was admitted to the hospital. VERY horrible long story short, she passed away at age 30 from colon cancer. The gastroenterlogist in Medford refused to let her have a colonoscopy when she requested twice for it. So for a few years she had a tumor growing unbeknownst to anyone. She suffered a lot from it, but the doctors just called her a drug addict and a mental case. (both ….she was NOT)
    I will be heartbroke and alone forever and her children are affected as well of course.

  2. Cecelia

    There are other factors besides medical negligence. Patients push for earlier discharge. Those with CHF are eating more high sodium holiday foods leading to re admissions. The holidays are an emotionally difficult time for many, deeply depressing for some, on top of the short days of December. For those at end of life, the goal another Christmas or family gathering has been met, allowing some to “let go”. So a few more factors to add to the puzzle.

  3. Dagonet

    Doctors are brilliant just before Christmas, and moronic afterwards. The hospital census drops just before Christmas because doctors cure everybody. Right after Christmas, the census rises as doctors send more patients to the hospital and they forget how they just learned how to cure everybody. Ask any hospital nurse, pharmacist, administrator,…

  4. Fran

    As a retired hospital social worker, I can affirm this. If you have a loved one in the hospital at this time, make certain a social worker/nurse/discharge planner is involved. This is a necessary and required part of any hospitalization; be assertive in asking for it if it doesn’t occur naturally. The earlier the discharge planner is involved, the better. If you have any misgivings that the patient is being discharged too early make your concerns known. If home health services are going to be involved, make certain you know which agency and when they plan to visit. Insurance plans will not cover additional days for the convenience of the patient and family, however, if readmission is a possibility they will. Find out who the insurance company representative assigned to your loved one’s case is and talk to them yourself if necessary. Make them aware of any difficulties caring for the patient at home. Also ask about community resources available to you, such as home delivered meals and volunteer services. Taking these steps early in the hospitalization process rather than on the day of discharge will help and you can welcome your loved one home with peace of mind.

  5. clyde

    My wife was released from a local hospital in 2 days after hip replacement before she could walk and was still under drug confusion, She was released to her 86 year old husband for care. In a day she had to taken back to the hospital because she could not be cared for in a confused state. A friend of ours was released from open heart surgery before she was stable with problems. It appears that the hospitals get paid more from medicare if they release them quickly.

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