The 'July Effect': A Look at July Medical Admissions in Teaching Hospitals
| Autor: | Lisa D Mims, Maribeth Porter, Peter J. Carek, Kit N. Simpson |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
July effect medicine.medical_specialty Myocardial Infarction Personnel Staffing and Scheduling Charlson index Logistic regression Teaching hospital 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology medicine Humans 030212 general & internal medicine Myocardial infarction Hospitals Teaching Aged Quality of Health Care Aged 80 and over Heart Failure business.industry Public Health Environmental and Occupational Health Health Care Costs Pneumonia Length of Stay Middle Aged medicine.disease Quarter (United States coin) Confidence interval Hospitalization Education Medical Graduate Heart failure Emergency medicine Female Family Practice business |
| Zdroj: | The Journal of the American Board of Family Medicine. 30:189-195 |
| ISSN: | 1558-7118 1557-2625 |
| DOI: | 10.3122/jabfm.2017.02.160214 |
| Popis: | Purpose We examined the effect of admission for myocardial infarction, heart failure, or pneumonia during the first academic quarter compared with all other quarters in teaching versus nonteaching hospitals on length of stay, cost, and mortality. Methods Using data 2011 Nationwide Inpatient Sample, multivariable modeling with an interaction term was used to test teaching hospital effect by academic quarter. Logistic regression was used for mortality and log-transformed linear models for cost and length of stay. Results Charlson Index scores were similar in teaching and nonteaching hospitals. Patients admitted to teaching hospitals for myocardial infarction in the first quarter had a higher risk-adjusted mortality (1.217; confidence interval, 1.147-1.290) than those admitted to a nonteaching hospital during the same quarter (0.849; confidence interval, 0.815-0.885). Mean cost heart failure admissions averaged $584 more, and the mean length of stay was longer (0.10; P = .0127), during the first academic quarter. These effects were not present for quarters 2 through 4. Conclusions This study suggests small increases in mortality among patients admitted with myocardial infarction in the first academic quarter compared with all other quarters in teaching versus nonteaching hospitals. Increased cost and longer stay were seen for those admitted with heart failure. |
| Databáze: | OpenAIRE |
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