The July Effect: Why Summer is the Most Dangerous Time to go to the Hospital

You can’t control when health emergencies occur, but if you had to go to the hospital, you’d probably be better off avoiding the summer months.

At least that’s been the conventional wisdom among doctors, who know that the most experienced medical residents graduate and leave hospitals in July, just as newly minted M.D.s (i.e., last year’s medical students) arrive to start caring for their first patients. A study confirms the trend, taking the a comprehensive look at death rates and complications occurring in hospitals throughout the year.

Reporting in the Annals of Internal Medicine, Dr. John Young of the University of California, San Francisco, and his team show that at teaching hospitals responsible for training new doctors, patient death rates increase while efficiency in patient care decreases during the month of July. In these hospitals, admitted patients serve as case studies used to educate future physicians on the best way to provide care; medical residents spend anywhere from three to six years as doctors-in-training, shadowing more experienced physicians as they learn how to diagnose and treat patients.

Come July, the most experienced residents graduate, leaving behind those who haven’t logged as many hours in the clinic or in patient wards. The older residents’ departure also coincides with the entry of a new class of freshman residents — new doctors who are taking on the responsibility of patient care for the first time.

Not surprisingly, the changeover can disrupt patient care in hospitals, increasing complications from surgery and boosting medical error rates, particularly as new doctors who are unfamiliar with a hospital’s pharmacy system mistakenly prescribe wrong doses of medications. The shift also decreases efficiency, with more unneeded or duplicate tests being ordered and patients being kept in the hospital longer than necessary.

Young’s study, which reviewed data from 39 previous studies that tracked health outcomes such as death and complications from medical procedures, found that death rates increased between 8% and 34% in July. That may be a wide range, but it’s the result of the first study to focus specifically on better-quality trials; the studies included in Young’s analysis controlled for other factors that may affect health outcomes, such as how sick patient populations were overall at the beginning of the studies.

 

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  1. #1 by V Antonelli on August 12, 2014 - 10:02 am

    Good info! Thanks!

    Like

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