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'July Effect' Has No Impact on Quality of Care in Stroke

Deaths, disabilities not found to increase with arrival of med school grads

'July Effect' Has No Impact on Quality of Care in Stroke

TUESDAY, Jan. 6, 2015 (HealthDay News) -- Researchers investigating the so-called "July effect" found that when recent medical school graduates begin their residency programs every summer in teaching hospitals, this transition doesn't reduce the quality of care for patients presenting with ischemic stroke.

For the study, published online Dec. 23 in the Journal of Stroke & Cerebrovascular Diseases, the researchers examined records on 10,319 patients who had an ischemic stroke between July 2003 and March 2008. The authors also analyzed length of hospitalization, referrals to long-term care facilities, and need for readmission or emergency room treatment for a stroke or any other reason in the month after their discharge.

More than 50 percent of all strokes are treated in teaching hospitals, the study's authors noted. They suggested the lack of training among new residents in July may be offset by the fact that stroke patients are treated by a multidisciplinary team of specialists. "Stroke teams usually include an emergency physician's initial assessment, a neurologist, neuroradiologist, physical therapists, occupational therapist, nurse, and dietitian, so the addition of new personnel may have less of an effect with strokes compared to other health issues," lead author Gustavo Saposnik, M.D., director of the Stroke Research Center at St. Michael's Hospital in Toronto, said in a hospital news release.

The researchers also speculated that the July effect may not be noticeable after a month. "Thirty days after a stroke, any July effect may have already leveled off. More research is needed to understand the possible impact of less-experienced care during the initial moments of stroke management to be sure no July effect is at play at any point of stroke care," Saposnik said. "Interestingly, we found that ischemic stroke patients admitted in July were less likely to receive clot-busting drugs or be admitted to stroke units, but ultimately, patients did just as well regardless of the month."

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