NCPA - National Center for Policy Analysis


July 16, 2010

If you've made it halfway through July without being hospitalized, and avoided the intensive care unit (ICU) on a weekend, consider yourself lucky.  Two new studies suggest that there are certain times when it's dangerous, even deadly, to seek hospital care, validating what doctors, nurses and other health care workers have said privately for years. 

In one recent study, researchers from the University of California at San Diego found that fatal medication errors rose 10 percent in July in U.S. counties with teaching hospitals, giving credence to what's long been known as the "July effect." 

That's the notion that deaths go up in July, the month that just-graduated medical residents start their new jobs, likely because of mistakes caused by inexperience, said David P. Phillips, the sociology professor who led the analysis. 

  • He examined more than 62 million U.S. death certificates from 1979 to 2006 and found a spike only in July.
  • He also found that the jump was higher in counties with greater concentrations of teaching hospitals.  

"The best available explanation was that this increase was associated with changes associated with the new residents," said Phillips, whose study was published in the Journal of General Internal Medicine. 

Another study, an analysis of 10 previous studies, found that people admitted to intensive care units on weekends were, on average, about 8 percent more likely to die than people admitted during the week. 

"The reason is kind of obvious," said Dr. Paul E. Marik, a Norfolk, Va., internist who helped conduct the study published in the journal CHEST.  "While patients don't decide when they get sick and they can't choose the day, hospitals operate as if they were the 7-11." 

Scant off-hours staffing and other administrative problems -- including low doctor-to-patient ratios and difficulty obtaining necessary tests and therapies -- likely contribute to the increased weekend deaths in the ICU, Marik said. 

"Hospitals should operate on the same level during the day as at night," he said.  "People should get the same level of care every day of the week." 

Source: JoNel Aleccia, "Hospitals really can be deadlier in July, study shows; Also, ICU deaths spike on weekends. What's a worried patient to do?", July 15, 2010. 

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