ArticleJournal of graduate medical education2014
A "reverse july effect": association between timing of admission, medical team workload, and 30-day readmission rate.
Article in Journal of graduate medical education, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- Safety in Numbers: A Scoping Review of Patient Census and Patient Outcomes.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Impact of staff turnover on extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients: a nationwide registry-based analysis in Japan.Resuscitation plus · 2025Article
- Acquisition of patients' EHR information under ED congestion - an empirical investigation.Health systems (Basingstoke, England) · 2025Review
- Exploring the 'January effect' at a university hospital in Pakistan: a retrospective cohort study investigating the impact of trainee turnover on patient care quality outcomes.BMC medical education · 2023Article
- Hospitalization and Post-hospitalization Outcomes Among Teaching Internal Medicine, Employed Hospitalist, and Locum Tenens Hospitalist Services in a Tertiary Center: a Prospective Cohort Study.Journal of general internal medicine · 2021Article
- Deconstructing the "July Effect" in Operative Outcomes: A National Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2016Article
- Impact of Resident Rotations on Critically Ill Patient Outcomes: Results of a French Multicenter Observational Study.PloS one · 2016Observational
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh teaching team workload has been associated with poor supervision and worse patient outcomes, yet it is unclear whether this association is more pronounced during the early months of the academic year when the residents are less experienced.
objectiveWe examined the associations between teaching team workload, timing of admission, and the 30-day readmission rate.
methodsIn this retrospective observational study, all admissions to an urban internal medicine teaching service over a 16-month period were divided into 2 groups based on admission date: early in the academic year (July-September) or late (October-June) and further defined as being admitted to "busy" versus "less busy" teams based on number of monthly admissions. The primary outcome was 30-day readmission rate. Multivariate logistic regression was used to determine the independent association between teaching team workload and readmission rates, stratified by time of year of admission after adjustment for demographic and clinical characteristics.
resultsOf 12 118 admissions examined, 2352 (19.4%) were admitted early in the year, and 9766 (80.6%) were admitted later. After multivariate adjustment, we found that patients admitted to busy versus less busy teams in the first quarter had similar 30-day readmission rate (odds ratio [OR]adj = 1.03 [0.82-1.30]). Later year admission to a busy team was associated with increased risk of readmission after adjustment (ORadj = 1.16 [1.03-1.30]).
conclusionsAdmission to busy teams early in the year was not associated with increased odds of 30-day readmission, whereas admission later in the year to busy teams was associated with 16% increased odds of readmission.
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Registered trials
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