Mortality among high-risk patients admitted with septic shock to U.S. teaching hospitals in July: Does the 'July Effect' exist?

Abstract

Background: The 'July effect' is a phenomenon of inferior delivery of care at teaching hospitals during July because of relative inexperience of new physicians.

Objective: To study the difference in mortality among septic shock patients during July and another month.

Methods: Using the U.S. Nationwide Inpatient Sample, we estimated the difference in mortality among septic shock patients admitted during May and July from 2003 to 2011.

Results: 117,593 and 121,004 patients with septic shock were admitted to non-teaching and teaching hospitals, respectively, in May and July. High-risk patients had similar mortality rates in non-teaching hospitals and teaching hospitals. Mortality rates were higher in teaching versus non-teaching hospitals in high-risk patients both in May and July. Overall, mortality rates were higher in teaching versus non-teaching hospitals both in May and July.

Conclusion: Similar trends in mortality are observed in both settings in May and July and no "July effect" was observed.

Keywords: July effect; Non-teaching hospital; Sepsis mortality; Septic shock; Teaching hospital.