A “Reverse July Effect”: Association Between Timing of Admission, Medical Team Workload, and 30-Day Readmission Rate

Abstract

Abstract Background High teaching team workload has been associated with poor supervision and worse patient outcomes, yet it is unclear whether this association is more pronounced during the early months of the academic year when the residents are less experienced. Objective We examined the associations between teaching team workload, timing of admission, and the 30-day readmission rate. Methods In this retrospective observational study, all admissions to an urban internal medicine teaching service over a 16-month period were divided into 2 groups based on admission date: early in the academic year (July–September) or late (October–June) and further defined as being admitted to “busy” versus “less busy” teams based on number of monthly admissions. The primary outcome was 30-day readmission rate. Multivariate logistic regression was used to determine the independent association between teaching team workload and readmission rates, stratified by time of year of admission after adjustment for demographic and...