Should the New Doctors be Blamed for in – Hospital Mortality?

Abstract

Background: This is a common apprehension that in – hospital mortality increases when a batch of new house officers starts working. We have analyzed whether there is a statistically significant increase in death rate in the last working month of the outgoing house officers as compared to first working month of the new batch.
Objective: The objective of this study was to see the difference in hospital mortality among patients followed by new and experienced house physicians.
Methodology: A retrospective study was conducted in the medical unit 4, a 60 bedded unit in Services Hospital Lahore, which is a tertiary care teaching hospital. Two groups were made comprising of senior house physicians and number of deaths during their last working month and new house physicians and the number of deaths among patients during their first working month.
Result: According to P value of Mantel - Haenszel (p – value = 0.682), it is clearly shown that death rate is statistically same in first and last month of house job. The crude odd’s ratio of years 2004, 2005 and 2007 was however higher in the last month of house job as compared to 2006 and 2008 where risk of mortality was higher in first month of house–job as OR is greater than 1. All the Odd’s Ratios from 2004 to 2008 give insignificant differences in risk of mortality.
Conclusion: We found no significant difference in in-hospital mortality among patients looked after by new or experienced house physicians.
Key Words: House physician, in-hospital mortality, turn – over, supervised training, death rate.