Planning a Hospital Stay: Beware of the July Effect

July 9, 2013

Patients admitted to teaching hospitals in July are slightly more likely to die during their stay and tend to have longer hospital stays and higher hospital charges, according to a study published by the Annals of Internal Medicine.

Why? Possibly because July is when experienced trainees graduate and new, less experienced ones start. Researchers from the University of San Francisco School of Medicine reviewed 39 studies to determine the effect of trainee changeover on patient outcomes. They noted that while there was considerable variation among hospitals, overall patients tended to fare worse in the month of July.

The UC-San Diego study, conducted by sociology professor David Phillips and his research associate, Gwen Barker, examined 244,388 United States death certificates issued from 1979 to 2006. The researchers focused on fatal medication errors as the recorded primary cause of death, comparing the number of deaths in July with the number of expected events in a given month for a given year. Phillips and Barker found that fatal medication errors spiked in July and in no other month. The increase, about 10 percent above the expected level for such events, was visible only in counties with teaching hospitals. No similar link was observed for other causes of death or for deaths outside hospitals.

Though the information studied included little data about the cause of the medication errors, Barker and Phillips concluded that the spike seemed to stem at least partly from changes associated with new medical residents. According to the nonprofit Kaiser Family Foundation, there are more than 16,000 medical graduates in the U.S. every year. In Fairfield County, there are 26 residency programs at six hospitals – Bridgeport Hospital, St. Vincent’s Medical Center in Bridgeport, Greenwich Hospital, Stamford Hospital, Danbury Hospital and Norwalk Hospital – with a total of about 300 to 400 residents in training any given year.

(as reported by Consumer Reports and Amanda Cuda in the Connecticut Post)

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