June 25, 2002 Friday is the most common day for patients to be discharged from hospital. A study in this issue of the Canadian Medical Association Journal indicates that patients sent home on Friday are also more likely to die or be readmitted to the hospital.
Carl van Walraven and Chaim Bell examined associations between discharge day and rates of death and readmission within 30 days of discharge among adults discharged from Ontario hospitals between Mar. 1, 1990, and Mar. 1, 2000. They found that patients released on Fridays "were significantly more likely to have an event" causing death or readmission to hospital than patients in the reference group (people discharged on Wednesdays). Among the more than 2.4 million eligible patients, the authors controlled for potential confounders including age, sex, comorbidities, prior nonelective admissions, length of stay, whether a procedure was performed and whether a complication occurred in hospital.
The authors speculate that the increased risk may be due to delays in providing social services or to the provision of incomplete discharge information due to increased demands on hospital staff at the end of the week. Regardless of the reason, the authors "suggest that clinicians keep this observation [about Friday discharges] in mind if they consider pushing to get patients home for the weekend."
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