7月入住美国教学医院的感染性休克高危患者的死亡率：“七月效应”是否存在？
Mortality among high-risk patients admitted with septic shock to U.S. teaching hospitals in July: Does the 'July Effect' exist?
作者信息
Saqib Amina, Ibrahim Uroosa, Patel Parshva, Joshi Abhyudaya, Chalhoub Michel
机构信息
Department of Pulmonary/Critical Care, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA.
Department of Hematology/Oncology, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA.
出版信息
Heart Lung. 2017 Mar-Apr;46(2):110-113. doi: 10.1016/j.hrtlng.2017.01.010. Epub 2017 Feb 22.
BACKGROUND
The 'July effect' is a phenomenon of inferior delivery of care at teaching hospitals during July because of relative inexperience of new physicians.
OBJECTIVE
To study the difference in mortality among septic shock patients during July and another month.
METHODS
Using the U.S. Nationwide Inpatient Sample, we estimated the difference in mortality among septic shock patients admitted during May and July from 2003 to 2011.
RESULTS
117,593 and 121,004 patients with septic shock were admitted to non-teaching and teaching hospitals, respectively, in May and July. High-risk patients had similar mortality rates in non-teaching hospitals and teaching hospitals. Mortality rates were higher in teaching versus non-teaching hospitals in high-risk patients both in May and July. Overall, mortality rates were higher in teaching versus non-teaching hospitals both in May and July.
CONCLUSION
Similar trends in mortality are observed in both settings in May and July and no "July effect" was observed.
背景
“七月效应”是指由于新医生相对缺乏经验，教学医院在7月的医疗服务质量较差的一种现象。
目的
研究7月与其他月份脓毒症休克患者死亡率的差异。
方法
利用美国全国住院患者样本，我们估算了2003年至2011年5月和7月入院的脓毒症休克患者的死亡率差异。
结果
5月和7月，分别有117,593例和121,004例脓毒症休克患者入住非教学医院和教学医院。高危患者在非教学医院和教学医院的死亡率相似。5月和7月，高危患者在教学医院的死亡率均高于非教学医院。总体而言，5月和7月教学医院的死亡率均高于非教学医院。
结论
5月和7月在两种环境中均观察到相似的死亡率趋势，未观察到“七月效应”。
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