Rationale, aims and objectives The July/August Phenomenon is a period when the

quality of care in hospitals is thought to decrease due to summer vacation stand-ins and new

staff. The results of studies on the veracity of this claim have been conflicting. This study

investigates the situation in internal medicine.

Methods Registry data of patients treated in internal medicine wards between 1 July 2000

and 30 November 2009 were obtained and analysed.

Results There were no differences in mortality during the July admissions compared with

those in November when adjusting for age, diagnosis, gender and year [for the overall data

risk ratio (RR) = 1.10, 95% confidence interval (CI) 1.00–1.23, P = 0.06; for the university

hospitals RR = 1.10, 95% CI 0.91–1.33, P = 0.34; for the non-university hospitals

RR = 1.10, 95% CI 0.97–1.26, P = 0.13]. The duration of admission (overall mean 4.5,

standard deviation 6.0) was equal between July and November when adjusted for age,

diagnosis, gender and year in all groups (overall data: RR = 1.00, 95% CI 0.99–1.02,

P = 0.83; university hospitals RR = 1.02, 95% CI 0.99–1.04, P = 0.13; non-university

hospitals RR = 1.00, 95% CI 0.98–1.01, P = 0.67).

Conclusions The quality of care in Finnish internal medicine wards in July seems

to equal November. Our results do not support the existence of a July Phenomenon in

Finland.