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Tuesday, December 11, 2018

Patients discharged during the December holidays have an increased risk of death or readmission up to a month after being sent home


December 10, 2018 Toronto

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.

Higher risk of death or readmission for patients discharged from hospital during December holidaysClick image to enlarge

“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: the home for the holidays cohort study,” is published in the December 10th issue of the BMJ.

ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. In October 2018, the institute formerly known as the Institute for Clinical Evaluative Sciences formally adopted the initialism ICES as its official name. For the latest ICES news, follow us on Twitter: @ICESOntario

For more information, please contact:

Deborah Creatura
Media Advisor, ICES
deborah.creatura@ices.on.ca
(o) 416-480-4780 or (c) 647-406-5996

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