The quality of internal medicine hospital care during summer holiday season

Abstract

<p> Rationale, aims and objectives The July/August Phenomenon is a period when the<br /> quality of care in hospitals is thought to decrease due to summer vacation stand-ins and new<br /> staff. The results of studies on the veracity of this claim have been conflicting. This study<br /> investigates the situation in internal medicine.<br /> Methods Registry data of patients treated in internal medicine wards between 1 July 2000<br /> and 30 November 2009 were obtained and analysed.<br /> Results There were no differences in mortality during the July admissions compared with<br /> those in November when adjusting for age, diagnosis, gender and year [for the overall data<br /> risk ratio (RR) = 1.10, 95% confidence interval (CI) 1.00–1.23, P = 0.06; for the university<br /> hospitals RR = 1.10, 95% CI 0.91–1.33, P = 0.34; for the non-university hospitals<br /> RR = 1.10, 95% CI 0.97–1.26, P = 0.13]. The duration of admission (overall mean 4.5,<br /> standard deviation 6.0) was equal between July and November when adjusted for age,<br /> diagnosis, gender and year in all groups (overall data: RR = 1.00, 95% CI 0.99–1.02,<br /> P = 0.83; university hospitals RR = 1.02, 95% CI 0.99–1.04, P = 0.13; non-university<br /> hospitals RR = 1.00, 95% CI 0.98–1.01, P = 0.67).<br /> Conclusions The quality of care in Finnish internal medicine wards in July seems<br /> to equal November. Our results do not support the existence of a July Phenomenon in<br /> Finland.</p>