Open AccessJournal Article
July-As Good a Time as Any to be Injured: Erratum
TLDR
Outcomes were similar between patients injured at the beginning of the academic year compared with the end of theademic year, and the concept of a July effect in level I trauma centers is not supported.Abstract:
BACKGROUND\nRecent studies have suggested worse outcomes for patients hospitalized during the beginning of the academic calendar, though these findings have not been reproduced among trauma patients. This study compares outcomes of patients during the beginning of the academic year with those at the end of the academic year.\n\n\nMETHODS\nRetrospective trauma registry analysis of a large urban level I trauma center. Patients admitted during April/May (ENDYEAR group) or July/August (FRESH group) between 1998 and 2007 were included. Demographic and injury parameters were recorded, and outcomes compared including crude mortality, complication rate, length of stay (LOS), and intensive care unit LOS (ICU-LOS). TRISS methodology was used to evaluate risk-adjusted performance.\n\n\nRESULTS\nThree thousand sixty-seven patients were included in the FRESH group and 3626 in the ENDYEAR group. Groups were similar in age (36 +/- 17 years and 36 +/- 17 years, p = 0.39) and mean Injury Severity Score (8 +/- 11 and 8 +/- 10, p = 0.85). There was no difference in LOS (4.6 +/- 0.2 days versus 4.5 +/- 0.2 days, p = 0.92) or ICU-LOS (5.6 +/- 0.2 days versus 5.3 +/- 0.2 days, p = 0.96). Per patient complication rates for the FRESH and ENDYEAR groups were 6% and 6% (p = 0.8), total complication rates were 12% and 13% (p = 0.07), and crude mortality was 7% and 6% (p = 0.11), respectively. FRESH and ENDYEAR groups had similar W-Statistics (1.0 and 1.2) and z scores (3.5 and 4.4).\n\n\nCONCLUSION\nOutcomes were similar between patients injured at the beginning of the academic year compared with the end of the academic year. Our data does not support the concept of a July effect in level I trauma centers.read more
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References
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Journal ArticleDOI
“July Effect”: Impact of the Academic Year-End Changeover on Patient Outcomes: A Systematic Review
TL;DR: In this article, it is commonly believed that the quality of health care decreases during trainee academic year-end changeovers, and it is shown that quality decreases during the changeover period.
Journal ArticleDOI
Comparison of surgical outcomes between teaching and nonteaching hospitals in the Department of Veterans Affairs
Shukri F. Khuri,Samer F. Najjar,Jennifer Daley,Barbara Krasnicka,Barbara Krasnicka,Monir Hossain,Monir Hossain,Monir Hossain,William G. Henderson,William G. Henderson,J. Bradley Aust,J. Bradley Aust,J. Bradley Aust,Barbara L. Bass,Michael J. Bishop,John G. Demakis,John G. Demakis,John G. Demakis,Ralph G. DePalma,Ralph G. DePalma,Ralph G. DePalma,Peter j. Fabri,Aaron S. Fink,Aaron S. Fink,James Gibbs,James Gibbs,Frederick L. Grover,Karl E. Hammermeister,Gerald O. McDonald,Gerald O. McDonald,Gerald O. McDonald,Leigh Neumayer,Leigh Neumayer,Leigh Neumayer,Robert H. Roswell,Robert H. Roswell,Jeannette Spencer,Jeannette Spencer,Jeannette Spencer,Richard H. Turnage +39 more
TL;DR: Despite good quality of care in teaching hospitals, as evidenced by the 30-day mortality data, efforts should be made to examine further the structures and processes of surgical care prevailing in these hospitals.
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Seasonal Variation in Surgical Outcomes as Measured by the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP)
Michael J. Englesbe,Shawn J. Pelletier,John C. Magee,Paul G. Gauger,Tracy L. Schifftner,William G. Henderson,Shukri F. Khuri,Darrell A. Campbell +7 more
TL;DR: The data suggests higher rates of postsurgical morbidity and mortality related to the time of the year, and further study is needed to fully describe the etiologies of the seasonal variation in outcomes.
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The Relationship of House Staff Experience to the Cost and Quality of Inpatient Care
TL;DR: The process of training inexperienced physicians may represent an important source of inefficiency for teaching hospitals struggling in a competitive environment, and the relationship of house staff experience to the cost and quality of inpatient care in one teaching hospital is studied.
Journal ArticleDOI
A systematic review of the effects of residency training on patient outcomes.
TL;DR: A systematic review of residency training and graduate medical education and patient outcomes found that adequate supervision, room for extra operation time, and evaluation of and attention to the individual competence of residents throughout residency training could positively serve patient outcomes.