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Related Experiment Videos

Do regulations limiting residents' work hours affect patient mortality?

David L Howard1, Jeffrey H Silber, David R Jobes

  • 1Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Journal of General Internal Medicine
|January 30, 2004
PubMed
Summary

New York regulations limiting resident work hours did not significantly impact patient mortality for common conditions. Analysis showed similar mortality trends in teaching and non-teaching hospitals before and after the regulations.

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Area of Science:

  • Healthcare policy analysis
  • Medical education research
  • Patient safety and outcomes

Background:

  • New York State implemented regulations in 1989 to limit the work hours of internal medicine and family practice residents.
  • Concerns existed regarding the potential impact of these work hour limitations on patient mortality and quality of care.

Purpose of the Study:

  • To evaluate the effect of New York's resident work hour regulations on in-hospital patient mortality.
  • To compare mortality trends in teaching hospitals subject to the regulations with non-teaching hospitals as controls.

Main Methods:

  • Retrospective analysis of inpatient discharge data from New York teaching and non-teaching hospitals.
  • Data from 1988 (pre-regulation) and 1991 (post-regulation) were compared for adult patients with congestive heart failure, acute myocardial infarction, or pneumonia.

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Main Results:

  • Overall in-hospital mortality declined between 1988 and 1991 in both teaching and non-teaching hospitals.
  • Adjusted mortality rates also decreased significantly in both settings, with no statistically significant difference between teaching and non-teaching hospitals (P =.4348).

Conclusions:

  • New York's mandated resident work hour limitations did not demonstrate a significant positive or negative effect on in-hospital mortality for the studied conditions.
  • The observed mortality decline was a trend consistent across both teaching and non-teaching hospitals, suggesting other factors may be influential.