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Holiday hospitalization carries higher risks, study says

Research has shown that going to the hospital in July or over the weekend can be riskier for patients becaus...

Posted: Dec 11, 2018 8:24 AM
Updated: Dec 11, 2018 8:24 AM

Research has shown that going to the hospital in July or over the weekend can be riskier for patients because of factors such as medical errors, understaffing or staff fatigue. The holiday period can also be added to the list, according to a new study.

"In taking care of patients who are admitted over the December holiday period, I had noticed, along with my colleagues -- we all kind of had this anecdotal experience, or maybe just more of a myth -- that discharging patients over the holidays was a little riskier," said Dr. Lauren Lapointe-Shaw, one of the authors of the study, published Monday in the BMJ.

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Lapointe-Shaw is also a Ph.D. student at the University of Toronto and a general internist physician at Toronto General Hospital.

She and her co-authors looked at the records of 670,946 patients discharged from acute-care hospitals in Ontario between April 1, 2002, and January 31, 2016. They compared discharges in three periods: the Christmas period, which included Christmas and New Year's, and two control periods, two-week stretches four weeks before and after the holidays.

The researchers also looked at the scheduling of follow-up appointments within seven and 14 days and the risk of death or readmission to the hospital within seven, 14 and 30 days.

Roughly a third of the patients -- 217,305 -- were discharged during the holiday period. "They had a small increased risk, and they were considerably less likely to have the follow-up with the physician," Lapointe-Shaw said.

Patients who were discharged in the holiday period had a 36.3% chance of a physician follow-up in seven days and a 59.5% chance of a physician follow-up in 14 days. For those in the control groups, the rates were 47.8% and 68.7%, respectively.

When it came to death or readmission, the patients discharged during the Christmas period were 13.3% more likely to be readmitted or to die within seven days, 18.6% in 14 days and 25.9% in 30 days. For the control groups, the risk rates were 11.7%, 17% and 24.7%, respectively.

The study found that "per 100,000 patients, 26 excess deaths, 188 excess rehospitalizations, 483 excess visits to an emergency department, and 2,999 fewer follow up appointments could be attributed to being discharged from hospital during the December holidays."

"Something is happening differently for these patients," Lapointe-Shaw said. "They are at higher risk, and despite that, they are not getting as much of the optimal transitional care that we would like them to get."

Dr. Seth Goldstein, an associate professor of surgery at Northwestern University Feinberg School of Medicine, noted that "over the past few years, there's been a bit of a spotlight on hospital systems and how to maintain quality of care 24/7.

"I think what this study does is points out that it's not unique to nights and weekends," he said. He believes that reduced hospital staffing, and a time when patients are less likely to want to be in the hospital, could have this effect.

Goldstein, who was not involved in the study, is also a pediatric general and thoracic surgeon at the Ann & Robert H. Lurie Children's Hospital of Chicago.

"I think the effect is probably real, and there are potential patient factors and hospital factors that can play a role" in these increased risks, Goldstein said.

Patient factors include an unwillingness to be in the hospital during the holidays and a change in routine, including eating and drinking habits, he said. Hospital factors could include lower numbers of staff and quicker discharges of patients so they can be home for the holidays.

Goldstein says solutions for hospitals include ensuring that safety and quality mechanisms are in place and, for patients, "seek urgent, emergency care when the condition arises, and you shouldn't try to wait it out at home because it's Christmas."

The fact that researchers are looking into the issue is also important to him.

"It's a good study, because awareness is the first step of anything you'd ever do to try to tackle the problem a little more head-on," he said.

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 320107

Reported Deaths: 7378
CountyCasesDeaths
DeSoto22291269
Hinds20741421
Harrison18444317
Rankin13917282
Jackson13731249
Madison10270224
Lee10060176
Jones8473167
Forrest7834153
Lauderdale7263242
Lowndes6523150
Lamar636088
Lafayette6314121
Washington5426137
Bolivar4841133
Panola4671110
Oktibbeha466398
Pearl River4606147
Marshall4574105
Warren4440121
Pontotoc425973
Monroe4161136
Union415877
Neshoba4064180
Lincoln4009113
Hancock387087
Leflore3516125
Tate342586
Sunflower339491
Pike3372111
Alcorn327473
Scott320374
Yazoo314371
Adams308386
Itawamba305178
Copiah299966
Coahoma298984
Simpson298589
Tippah292268
Prentiss284261
Leake272274
Marion271280
Covington267283
Wayne264842
Grenada264087
George252251
Newton248963
Tishomingo232268
Winston230181
Jasper222148
Attala215173
Chickasaw210559
Holmes190374
Stone188733
Clay187954
Tallahatchie180041
Clarke178980
Calhoun174232
Yalobusha167840
Smith164134
Walthall135447
Greene131834
Lawrence131224
Montgomery128643
Noxubee128034
Perry127538
Amite126342
Carroll122330
Webster115032
Jefferson Davis108334
Tunica108127
Claiborne103130
Benton102325
Humphreys97533
Kemper96729
Franklin85023
Quitman82316
Choctaw79118
Wilkinson69632
Jefferson66328
Sharkey50917
Issaquena1696
Unassigned00

Alabama Coronavirus Cases

Cases: 549013

Reported Deaths: 11311
CountyCasesDeaths
Jefferson810461571
Mobile42145831
Madison35718525
Tuscaloosa26179458
Shelby25626254
Montgomery25089614
Baldwin21901314
Lee16287176
Calhoun14724327
Morgan14639285
Etowah14183364
Marshall12454230
Houston10791287
Elmore10301214
Limestone10188157
St. Clair10161251
Cullman9958201
Lauderdale9612250
DeKalb8977190
Talladega8462184
Walker7341280
Autauga7242113
Jackson6953113
Blount6950139
Colbert6415140
Coffee5638127
Dale4930116
Russell454941
Chilton4478116
Franklin431782
Covington4279122
Tallapoosa4144155
Escambia401880
Chambers3728124
Dallas3610158
Clarke353161
Marion3245107
Pike314578
Lawrence3134100
Winston283572
Bibb268564
Geneva258481
Marengo250665
Pickens237062
Barbour234559
Hale227178
Butler224671
Fayette218962
Henry194443
Randolph187644
Cherokee187345
Monroe180641
Washington170739
Macon163051
Clay160159
Crenshaw156357
Cleburne153644
Lamar146937
Lowndes142254
Wilcox126930
Bullock124542
Conecuh113630
Coosa111629
Perry108626
Sumter105832
Greene93634
Choctaw62125
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High pressure will continue to dominate our weather forecast over the next few days. This will at least keep our area dry for our Wednesday and maybe a little room for a few showers on our Thursday, however nothing major.
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