OpenLB
Open Library of Bioscience

OBJECTIVE: The period of resident turnover in teaching hospitals has been believed by some to lead to worsening of health outcomes or the so-called "July Effect". We sought to study glycemic control in patients admitted to medical floors looking for any adverse outcomes related to a"July effect".
METHODS: This is a single-center retrospective cohort study comparing inpatient glycemic control at the start and end of a single academic year (July 2009 to June 2010). A total of 100 inpatients with a diagnosis of diabetes mellitus were included in the first group (Group 1: July to September 2009) and 118 in the second group (Group 2: April to June 2010). Four capillary blood glucose measurements per day from Day 2 to Day 6 of hospitalization, as well as clinical data pertinent to glycemic management were collected.
RESULTS: Data analysis showed no significant difference in the overall inpatient glycemic control between the two groups. Mean glucose for Group 1 was 168.67 mg/dL and 168.59 mg/dl for Group 2. 67% of patients in Group 1 and 72.9% in Group 2 were within blood glucose range of 70 - 179 mg/dl, 32% of patients in Group 1 and 52% of patients in Group 2 were within the range of 140 - 179 mg/dL. Hypoglycemia occurred in 17% and 18.6% of patients for Group 1 and 2 respectively. No difference in diabetes treatment ordering practices of residents was detected.
CONCLUSION: This study did not show any evidence to support the "July Effect" on overall inpatient glycemic control.