Patients who were discharged during the holidays at greater risk, study says


Patients receiving discharge from Ontario, who were discharged during the December holiday period, are at a high risk of death or readmission, according to a new study.

The Institute of Clinical Trial Sciences analyzed patients leaving hospital care during the two-week winter vacation described in school calendars over a period of 14 years. They found that they had a higher chance of mortality or returned to the ER with a week, two weeks, or a month of discharge.

A study by the Institute of Clinical Trials found a greater chance of mortality or return to hospital for patients who were discharged during the December vacation period.
A study by the Institute of Clinical Trials found a greater chance of mortality or return to hospital for patients who were discharged during the December vacation period. (Richard Lautens / Stock Photo Toronto Star)

The same goes for patients who are discharged on Fridays or on weekends.

"In fact, we found that there was a small increase in the risk of patients having readmission or dying within three days and that they were actually much less likely to have follow-up within two weeks of discharge," said Lauren Lapointe -Shaw, PhD student at ICES and lead investigator in the study.

The study found that holiday sick leave is also less likely to accompany doctors after they leave the hospital. For every 100,000 patients, there were 2,999 fewer follow-up visits than two weeks, 26 excess deaths, 188 excess hospitalizations, and 483 extra visits to the emergency department during the vacation period.

Lapointe-Shaw said that this may be due, in part, to crowded schedules and festivities during the holidays, when an increase in activity can cause unloaded patients to push themselves too hard as they recover.

"There are riskier behaviors that continue," said Lapointe-Shaw. "More eating, drinking, more involvement in activities, which can certainly increase the risk. A medical condition would be destabilized. "

However, the patient's behavior is not the only culprit. Hospitals with few staff members may have difficulty transitioning patients out of hospitals while they try to stay on top of demand with fewer hands.

"So how do we plan for people to come home during the vacation, when hospitals tend to be relatively lower?" She said. "Often there is a large wave of patients related to the annual flu season and the resources may be in a lower supply."

Lapointe-Shaw said he realized the problem throughout his experience working on health care during the holidays and during discussions with doctors.

"If you're unloading someone at home during the holidays, are you kind of sending him off the cliff? Are they going to have the necessary follow-up?" She said.

Maryanne D "Arpino, senior director of the Canadian Patient Safety Institute, directly referenced the impact of the flu season during the holidays.

"Given the fact that flu cases are increasing, this may attribute a potential increase in more people trying to access emergency departments and potentially lead to an increase in hospital admissions," said D & # 39; Arpino to Star.

"We know that during discharge and care transitions, there is a greater risk of patient safety incidents, which can lead to readmissions."

D & # 39; Arpino also said that there are a number of readmission cases that could have been avoided, citing patient safety incidents, which "are based on avoidable, unintended outcomes of treatment care or medical complication, and not by the underlying disease. " may result in prolonged care, disability and possibly death.

With files by Bianca Bharti and Ilya Banares

Stefanie Marotta is a breaking news reporter, working in Star's radio room in Toronto. Follow her on Twitter: Stefanie Marotta


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