Featured Research

from universities, journals, and other organizations

Limiting Work Hours Of Medical Residents Could Cost $1.6 Billion Annually, Study Finds

Date:
May 20, 2009
Source:
RAND Corporation
Summary:
New Institute of Medicine recommendations to limit the work hours of medical residents could cost the nation's teaching hospitals about $1.6 billion annually to hire substitute workers, according to a new report. Researchers say the changes would create a substantial new expense for academic medical centers with no obvious way to pay the costs.

New recommendations to limit the work hours of medical residents could cost the nation's teaching hospitals about $1.6 billion annually to hire substitute workers, according to a new report from the RAND Corporation and UCLA.

While society may benefit if such changes reduce medical errors as intended, limiting trainee workloads would create a substantial new expense for academic medical centers, according to the study published in the May 21 edition of the New England Journal of Medicine.

"Adopting new restrictions on the work hours of physicians in training would impose a substantial new cost on the nation's 8,500 physician training programs," said lead author Dr. Teryl K. Nuckols, an internist at the David Geffen School of Medicine at UCLA and a researcher at RAND, a nonprofit research organization. "There is no obvious way to pay for these changes so that's one major issue that must be addressed."

In December, the Institute of Medicine released a report calling for revisions to medical residents' workloads to decrease the chances of fatigue-related medical errors and to enhance the learning environment. Recommendations include requiring prolonged shifts to include protected time for sleep, reducing to 16 hours the duration of time residents can work without protected time for sleep, reducing residents' workload, and increasing the number of days residents must have off.

Graduate medical education programs traditionally have required residents to work long hours, often more than 100 hours per week. Such training programs generally run three to seven years following medical school.

The study from RAND Health and UCLA provides new details about the potential costs and clinical implications of the Institute of Medicine recommendations, expanding upon a cost analysis described in the original report.

Should the recommendations be adopted, researchers say teaching hospitals would need to make up for residents' shorter work hours by either hiring other providers such as physician assistants to do the work or by expanding the number of residency positions.

While adding residency slots could help ease physician shortages in some specialties, it also could lead to oversupply in others, according to the study. Researchers estimate that residency positions would need to grow by about 8 percent overall to meet staffing needs under the IOM recommendations.

"The trainees who are working more than the proposed limits would allow are not necessarily in the specialties where more physicians are needed," Nuckols said. "For example, pediatric residents work a lot of hours, but there is no evidence that there are too few pediatricians."

Researchers estimate that adopting the Institute of Medicine's recommendations would cost each major teaching hospital about $3.2 million annually on average. That is higher than other proven quality improvement efforts for hospitals such as computerized physician order entry and medication bar-coding systems. But it would be less expensive than other proposals, such as requiring that there be one nurse for every four patients.

One study of shorter work shifts suggests that reducing resident work hours could cut serious medical errors by 25 percent in medical intensive care units. But few errors cause injury and the effects could be different in other clinical settings, according to the study. In addition, revising work rules could prompt other types of medical errors as the care of hospitalized patients is more-frequently handed from one provider to another.

Researchers say adopting the recommendations of the IOM report would be more expensive for teaching hospitals than a major revision of resident work hours adopted by training programs five years ago. Those rules say that residents should not work more than an average of 80 hours per week, among other limits.

"Residency programs already have picked much of the low-hanging fruit by reducing the non-educational duties placed on residents," Nuckols said. "Further changes will require that hospitals hire professionals with high levels of training, such as nurse practitioners and physicians, and that will be expensive."

Other authors of the study are Dr. Jose J. Escarce of RAND and UCLA, Dr. Jay Bhattacharya of Stanford University, and Dianne Miller Wolman and Cheryl Ulmer of the Institute of Medicine.

Support for the study was provided by the Institute of Medicine, under contract to the federal Agency for Healthcare Research and Quality.


Story Source:

The above story is based on materials provided by RAND Corporation. Note: Materials may be edited for content and length.


Cite This Page:

RAND Corporation. "Limiting Work Hours Of Medical Residents Could Cost $1.6 Billion Annually, Study Finds." ScienceDaily. ScienceDaily, 20 May 2009. <www.sciencedaily.com/releases/2009/05/090520181055.htm>.
RAND Corporation. (2009, May 20). Limiting Work Hours Of Medical Residents Could Cost $1.6 Billion Annually, Study Finds. ScienceDaily. Retrieved July 28, 2014 from www.sciencedaily.com/releases/2009/05/090520181055.htm
RAND Corporation. "Limiting Work Hours Of Medical Residents Could Cost $1.6 Billion Annually, Study Finds." ScienceDaily. www.sciencedaily.com/releases/2009/05/090520181055.htm (accessed July 28, 2014).

Share This




More Health & Medicine News

Monday, July 28, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Deadly Ebola Virus Threatens West Africa

Deadly Ebola Virus Threatens West Africa

AP (July 28, 2014) West African nations and international health organizations are working to contain the largest Ebola outbreak in history. It's one of the deadliest diseases known to man, but the CDC says it's unlikely to spread in the U.S. (July 28) Video provided by AP
Powered by NewsLook.com
$15B Deal on Vets' Health Care Reached

$15B Deal on Vets' Health Care Reached

AP (July 28, 2014) A bipartisan deal to improve veterans health care would authorize at least $15 billion in emergency spending to fix a veterans program scandalized by long patient wait times and falsified records. (July 28) Video provided by AP
Powered by NewsLook.com
Two Americans Contract Ebola in Liberia

Two Americans Contract Ebola in Liberia

Reuters - US Online Video (July 28, 2014) Two American aid workers in Liberia test positive for Ebola while working to combat the deadliest outbreak of the virus ever. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Traditional African Dishes Teach Healthy Eating

Traditional African Dishes Teach Healthy Eating

AP (July 28, 2014) Classes are being offered nationwide to encourage African Americans to learn about cooking fresh foods based on traditional African cuisine. The program is trying to combat obesity, heart disease and other ailments often linked to diet. (July 28) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins