Patients discharged from hospital during the festive period are at higher risk of death or re-admission, a study has found.
Limited access to care, difficulty in booking appointments and reduced levels of staffing could explain the findings, researchers said.
Experts analysed 217,305 cases of adults and children discharged from hospitals in Ontario, Canada, during the two-week December holiday period, between 2002 and 2016.
They compared this with 453,641 cases of patients discharged during two periods in late November and January, excluding groups likely to have different follow-up needs and risk of re-admission, such as pregnant women.
Those discharged during the holidays were found to have a higher risk of death or re-admission within the next seven, 14 and 30 days.
The study also found that those discharged during Christmas were a third (33.6 per cent) less likely to have a follow-up appointment within seven days, possibly because of wanting to postpone until after the festivities.
Overall, researchers found that per 100,000 patients, there were 26 excess deaths, 188 excess re-hospitalisations, and 483 extra visits to an emergency department associated with being discharged during the Christmas holiday.
The experts from the Institute for Clinical Evaluative Sciences (ICES) added that festive activities, such as increased alcohol intake and a lack of sleep, "could destabilise an acute medical condition".
Patients with a higher baseline risk, such as those with lung disease, had a lower holiday-related risk of re-admission and death than those with a lower baseline risk, which the authors suggest could be clinicians prioritising higher risk patients.
Researchers said the study, published in the British Medical Journal, may not be applicable to all populations, as follow-up rates can vary according to local community practices.
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The authors also added that they cannot rule out the possibility that some of the risk may be a result of other unmeasured factors.
