Is there some truth to this statement?
Published in the Annals of Internal Medicine, a recent study investigated the effect of intern changeover in the month of July. The authors systematically reviewed studies describing the effects of trainee changeover on patient outcomes. Thirty-nine studies were included in the final analysis: 27 (69%) reported mortality, 19 (49%) reported efficiency (length of stay, duration of procedure, hospital charges), 23 (59%) reported morbidity, and 6 (15%) reported medical error outcomes; all studies focused on inpatient settings.
Of the 13 studies with higher-quality designs and larger sample sizes, increased mortality and decreased efficiency was observed at time the time of intern changeover in the month of July. For the higher-quality studies showing an association between changeover and mortality, the effect size ranged from a relative risk increase of 4.3% to 12.0% or an adjusted odds ratio of 1.08 to 1.34. Not a huge difference, but not insignificant either
Other outcomes, such as morbidity and medical error outcomes, produced inconsistent results.
Mortality increases and efficiency decreases in hospitals because of year-end, intern changeovers. The authors were careful to point out several important caveats to this conclusion. The articles reviewed were English-language only, ambulatory settings were excluded, definitions of changeover and supervision structure varied significantly, likely resulting in confounding and bias.
Regardless, I will be sure to have my appendicitis later in the academic year.
