Monday, July 1, 2013

The July Effect- New Interns and Medical Errors

I am back from a few days off and fully ready for July 1st!

July 1st marks the beginning of a new academic year in university hospitals. On this day, freshly minted doctors (interns) begin their post-graduate medical training.


Here is an article published in the Journal of General Internal Medicine that reports the  possible impact of new residents on medical errors.

The investigators examined all U.S. death certificates, 1979-2006 (n = 62,338,584), focusing on medication errors (n = 244,388). The July Effect in was compared between counties with and without teaching hospitals.

Inside medical institutions, in counties containing teaching hospitals, fatal medication errors spiked by 10% in July and in no other month [JR = 1.10 (1.06-1.14)]. In contrast, there was no July spike in counties without teaching hospitals. The greater the concentration of teaching hospitals in a region, the greater the July spike (r = .80; P = .005). These findings held only for medication errors, not for other causes of death.

The conclusion: July mortality spike results at least partly from changes associated with the arrival of new medical residents. 

If at all possible, avoid hospitalization in a university hospital in July.

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