Teaching hospitals across the United States take on new residents and fellows during the month of July. Some believe that this changeover leads to poor quality of medical care while staff is adjusting to their new jobs, calling it the “July effect.”
A recent study compared the results of spinal surgery that took place in teaching hospitals in July to the results in other months of the year. According to the study, there were no more deaths or complications in July when there was an influx of new residents and fellows in hospitals than in any other months.
Any difference between quality of care in July and other months in teaching hospitals was small enough to be considered negligible.
Jennifer S. McDonald, PhD, of the Mayo Clinic in Rochester, Minnesota, and colleagues examined an existing database for cases involving spinal surgery between 2001 and 2008. The database contained more than one million spinal surgery hospitalizations during this time.
A teaching hospital is a hospital that allows new doctors, nurses and other health professionals to receive on the job training. Medical care is provided by these new health professionals under an experienced professional's supervision.
The researchers collected data on patient demographics, diagnoses, hospitalization details and hospital demographics for teaching and non-teaching hospitals.
The number of deaths, discharges and complications after surgery, length of hospital stay and total cost were analyzed for hospitals. The results for patients who were admitted to the hospital in July were compared to the results of those who were admitted in other months.
The teaching hospitals had a slightly higher rate of postoperative infection and patient discharge to a long-term facility during July than in other months. The difference between the two rates was small and only statistically significant because of the large number of study participants.
Rates of death and complications from surgery were not higher in teaching hospitals in July. Higher-risk patients, patients admitted for elective surgery and those undergoing simple spinal procedures did not see any “July effect.”
The authors concluded that any effect that was seen was so small that it could be considered negligible.
The study was published January 29 in the Journal of Neurosurgery: Spine.
The authors report no conflicts of interest.