The quality of internal medicine hospital care during summer holiday season.

Abstract

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