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. 2018 Jul;6(4):277-281.

The "July Effect" on Shoulder Arthroplasty: Are Complication Rates Higher at the Beginning of the Academic Year?

Daniel G Tobert  1   2   3   4   5 , Mariano E Menendez  1   2   3   4   5 , David C Ring  1   2   3   4   5 , Neal C Chen  1   2   3   4   5
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The "July Effect" on Shoulder Arthroplasty: Are Complication Rates Higher at the Beginning of the Academic Year?

Daniel G Tobert et al. Arch Bone Jt Surg. 2018 Jul.

Abstract

Background: The "July effect" is a colloquialism asserting an increased rate of errors at the start of the academic year in teaching hospitals. This retrospective population-based study evaluated for the presence of the July effect in performing shoulder arthroplasty.

Methods: Using the Nationwide Inpatient Sample for 2002 through 2011, a total of 178,590 patients undergoing shoulder arthroplasty at academic medical centers were identified and separated into 2 groups: 1) patients admitted during July and 2) patients admitted between August and June. Multivariable logistic regression was used to identify associations with inpatient mortality and adverse events, blood transfusion, prolonged length of stay (>75th percentile) and non-routine discharge.

Results: After adjusting for patient, procedure, and hospital characteristics in multivariable modeling, admission in July was not associated with increased risk for inpatient mortality (OR 1.6) aggregate morbidity, blood transfusion, prolonged length of stay, and non-routine discharge.

Conclusion: This nationwide database analysis shows that shoulder arthroplasty at academic medical centers is not associated with increased perioperative morbidity and resource utilization during the month of July.

Keywords: Complications; July effect; Nationwide inpatient sample; Resident education; Shoulder arthroplasty; Teaching hospitals.

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References

    1. Haller G, Myles PS, Taffe P, Perneger TV, Wu CL. Rate of undesirable events at beginning of academic year: retrospective cohort study. BMJ. 2009;339(1):b3974. - PMC - PubMed
    1. Phillips DP, Barker GE. A July spike in fatal medication errors: a possible effect of new medical residents. J Gen Intern Med. 2010;25(8):774–9. - PMC - PubMed
    1. Riguzzi C, Hern HG, Vahidnia F, Herring A, Alter H. The July effect: is emergency department length of stay greater at the beginning of the hospital academic year? West J Emerg Med. 2014;15(1):88–93. - PMC - PubMed
    1. Gopaldas RR, Overbey DM, Dao TK, Markley JG. The impact of academic calendar cycle on coronary artery bypass outcomes: a comparison of teaching and non-teaching hospitals. J Cardiothorac Surg. 2013;8(10):191. - PMC - PubMed
    1. Englesbe MJ, Pelletier SJ, Magee JC, Gauger P, Schifftner T, Henderson WG, et al. Seasonal variation in surgical outcomes as measured by the american college of surgeons-national surgical quality improvement program (ACS-NSQIP) Ann Surg. 2007;246(3):456–65. - PMC - PubMed

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