Tuesday, June 29, 2004

Kevin and Mr. Hawkins beat me to the punch on this New York Times story on the old "stay away from the hospital in July" story. Turns out that it's mostly bunk:
Several studies in the past few years have searched in vain for the phenomenon. One of the largest , published in The Journal of General Internal Medicine in 2003, compared hospital deaths and lengths of stay from July to September to the rates for other months in teaching and nonteaching hospitals. The researchers, Drs. William A. Barry and Gary E. Rosenthal of the University of Iowa Hospitals and Clinics in Iowa City, reviewed the records of more than 48,000 patients admitted to intensive care units in 28 hospitals in Ohio from 1991 to 1997. They found no significant difference in mortality rates or lengths of stay in the July-through-September period.

Of course, the study looked at the outcomes of very sick patients who were treated in intensive care units, where one would expect the highest degree of supervision, possibly obscuring a July effect. Other studies, however, have also failed to find differences in mortality rates for hospitalized patients in July.

But there are always exceptions:
But there is one group for whom a kind of July phenomenon might exist - psychiatric patients.

They are followed by residents in hospital clinics, usually for one or two years, and learn some time in the spring that they will have new psychiatrists in July. For many who have grown attached to their therapists, this can be more than just upsetting. It can be literally destabilizing.

A study at the Payne Whitney Clinic of New York-Presbyterian Hospital and published in Hospital and Community Psychiatry found a statistically significant increase in hospitalization rates in the three- month period after the resident changeover compared with other months.
The author goes on to write that it was so bad at one program that the program director forbade any vacations during July. Oh the horror!!! When I was a resident (walking to work barefoot in ten feet of snow uphill both ways....) we couldn't take vacations in June or July. What kind of resident would think about asking for a vacation in July anyway?
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