Trainee physician turnover and 30-day mortality in Korean intensive care units

Abstract

Purpose: Previous studies have found an increase in in-hospital mortality when trainee physicians rotate. Our retrospective cohort study investigated whether trainee physicians' turnover influenced 30-day mortality in Korean intensive care units (ICUs), which have high-intensity daytime intensivist coverage only on weekdays.

Materials and methods: Participants were adults over 19years old admitted to ICUs in a Korean tertiary care academic hospital between 2012 and 2016. Demographic and clinical data were collected on admission, and dates of death recorded. The primary outcome was the association between ICU admission in the turnover periods (March and May) and 30-day mortality after admission to ICUs with high-intensity daytime intensivist coverage.

Results: Overall, there was no significant correlation between ICU admission during turnover periods and 30-day mortality [hazard ratio (HR), 1.06; 95% confidence interval (CI), 0.83-1.35, P=0.647]; the same trend was found for ICU admissions when there was no intensivist coverage (HR: 1.24, 95% CI: 0.91-1.69, P=0.177).

Conclusions: We found no overall association between physician turnover and 30-day mortality of patients admitted to ICUs with high-intensity daytime intensivist coverage or with no intensivist coverage.

Keywords: Intensive care; Mortality; Physician turnover.