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Is Holiday Hospital Discharge More Hazardous?

Hospital discharge between Christmas and New Year's Day was linked to a higher likelihood of readmssion to the hospital and of premature death.

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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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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