July Effect Doesn’t Impact Stroke Care, Outcomes

HealthDay News — The so-called “July effect” marking the start of residency programs has no ill effect on the quality of care for patients with stroke.

For the study, published online in the Journal of Stroke & Cerebrovascular Diseases, the researchers examined records on 10,319 patients who had an ischemic stroke between July 2003 and March 2008. The authors also analyzed length of hospitalization, referrals to long-term care facilities, and need for readmission or emergency room treatment for a stroke or any other reason in the month after their discharge.

More than 50% of all strokes are treated in teaching hospitals, the study’s authors noted. They suggested the lack of training among new residents in July may be offset by the fact that stroke patients are treated by a multidisciplinary team of specialists. “Stroke teams usually include an emergency physician’s initial assessment, a neurologist, neuroradiologist, physical therapists, occupational therapist, nurse, and dietitian, so the addition of new personnel may have less of an effect with strokes compared to other health issues,” lead author Gustavo Saposnik, MD, director of the Stroke Research Center at St. Michael’s Hospital in Toronto, said in a hospital news release.

The researchers also speculated that the July effect may not be noticeable after a month. “Thirty days after a stroke, any July effect may have already leveled off. More 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,” Saposnik said. “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.”


  1. Park T et al. J Stroke Cerebrovasc Dis. 2014; doi:10.1016/j.jstrokecerebrovasdis.2014.09.030.