Recent research in stroke outcomes challenges concerns about the possibility of lower quality of care and potential risk of poorer outcomes in teaching hospitals when new medical residents start each July, reportedly known as the “July effect”. The study suggests that patients with acute ischemic strokes who were admitted in July exhibited similar outcomes when compared to patients admitted any other month.
Gustavo Saposnik, director of the Stroke Research Centre of St. Michael’s Hospital, scientist with the Institute for Clinical Evaluative Sciences, states in a news release from the Ontario, Canada-based hospital that the researchers found “there was no higher rate of deaths after 30 or 90 days, no poorer greater rates of disability or loss of independence and no evidence of a July effect for stroke patients.”
The release adds that the multidisciplinary nature of specialized stroke care may help compensate for the lack of experience among trainees. Saposnik points out that stroke teams usually include an emergency’s initial assessment, a neurologist, neuroradiologist, physiotherapists, occupational therapist, nurse and dietitian, “so the addition of new personnel may have less of an effect with strokes compared to other health issues,” he says.
An alternate potential explanation for the lack of a discernible July effect in stroke outcomes, the release adds, is that the impact of care is greatest immediately post-stroke and might not be noticeable at the end of a hospital stay. After 30 days post-stroke, any “July effect” may have leveled off, according to Saposnik. He emphasizes more is 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.”
The study, which appears in the Journal of Stroke and Cerebrovascular Diseases, encompassed 10,319 patients with acute ischemic strokes between July 1, 2003 and March 31, 2008.
“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,” Saposnik notes.
Additionally, the release says the research team investigated referrals to long-term care facilities at time of discharge from hospital, length of hospital stay, hospital readmissions or ED visits for any reason within 30 days from discharge from hospital and hospital readmission within 30 days from discharge due to stroke.
Source(s): ScienceDaily, St. Michael’s Hospital
