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Comment & Response
March 21, 2017

Transitions in House Staff Care and Patient Mortality

Author Affiliations
  • 1Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri

Copyright 2017 American Medical Association. All Rights Reserved.

JAMA. 2017;317(11):1178. doi:10.1001/jama.2017.1316

To the Editor Dr Denson and colleagues reported that patients whose hospitalizations spanned transitions in house staff care had higher mortality rates than control patients.1 The methods used to construct the transition and control cohorts may explain the findings. For patients admitted on a given day, only those patients who remained hospitalized until the end-of-rotation transition were eligible for inclusion in the transition group; patients who died or were discharged before the transition period were assigned to the control group. This method resulted in fundamentally unbalanced groups, whereby patients in the transition group had longer lengths of stay than those in the control group by 3 to 4 days.

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