Featured Research

from universities, journals, and other organizations

New limits on physician training hours could prove costly for US teaching hospitals

Date:
September 8, 2011
Source:
University of California - Los Angeles Health Sciences
Summary:
The new limits on hours that physicians-in-training can work will prove costly for USteaching hospitals, which will need to spend up to $1.3 billion a year, and possibly more, to effect the changes.

The new limits on hours that physicians-in-training can work will prove costly for U.S teaching hospitals, which will need to spend up to $1.3 billion a year, and possibly more, to effect the changes, a new UCLA study suggests.

On July 1, the Accreditation Council for Graduate Medical Education (ACGME), the national body charged with overseeing the training of junior doctors as they complete their specialty training, put into effect strict duty-hour limits on interns and medical residents and instituted related changes to the training environment.

These reforms are intended to reduce medical errors by physicians-in-training at teaching hospitals that result from fatigue due to long work hours, though the changes do not assure a reduction in error rates.

The new UCLA study, published online in the Journal of General Internal Medicine, estimates that teaching hospitals nationwide will have to spend an aggregate $400 million to $1.3 billion each year to carry out the new hour limits and related changes. But some hospitals might have trouble coming up with the money to do it.

"Given the effort and money that teaching hospitals are investing in implementing these new duty-hour limits, many people hope that these changes will reduce the numbers of patients being harmed by medical errors, as well as the number of residents falling asleep at the wheel after long hours on duty," said lead study author Dr. Teryl Nuckols, an associate professor of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA. "Our analysis shows that if the reforms are successful, they are likely to be a good value for the money from the societal perspective."

"However, some teaching hospitals may struggle with the cost of implementing the reforms because there is no funding for doing so," she added.

Under the new guidelines, first-year residents, also known as interns, can work a maximum of 16 hours continuously and must have on-site supervision at all times. More senior residents can work up to 28 consecutive hours when they are "on call" in all but exceptional circumstances. Under previous guidelines, both interns and senior residents could work up to 30 consecutive hours.

Changes in the training environment include educating residents and faculty members about fatigue and patient safety; standardizing the process of giving residents increasing autonomy as they advance through training toward becoming fully qualified physicians; systematizing hand-overs of patient care as one physician comes off duty and another physician comes on; providing transportation or sleep facilities after extended shifts; and establishing annual site visits by the ACGME.

Drawing from published literature and publicly available data sources, the researchers created models to examine the costs of hiring substitutes to perform the work of residents and the potential effects of the changes on rates of harmful medical errors and their associated costs.

They found:

  • The duty-hour changes will cost at least $177 million annually nationwide, based on the most optimistic assumptions about how changes might be implemented. However, under less optimistic assumptions, they could cost up to $982 million annually nationwide.
  • The associated changes to the training environment will cost an additional $204 million annually nationwide.
  • Considering the costs of the reforms and the benefits of reducing harmful medical errors, the reforms are likely to be considered cost-effective to society if medical errors fall by as little as 3 percent -- a relatively modest decline. However, teaching hospitals would lose money by implementing the reforms unless errors decline to a much greater degree -- at least 7.2 percent to 25.8 percent, depending on the cost of implementing the duty-hour changes.

The researchers also noted the ACGME's duty-hour limits are less expensive than those previously proposed by the Institute of Medicine, which would have cost $1.7 billion. Nevertheless, the price tag for these reforms is sizeable.

The study has some weaknesses, the researchers noted. For instance, while the analysis was able to consider the cost of different implementation strategies, the researchers do not yet know which strategies are best for preventing medical errors or for educating future doctors.


Story Source:

The above story is based on materials provided by University of California - Los Angeles Health Sciences. Note: Materials may be edited for content and length.


Journal Reference:

  1. Teryl K. Nuckols, José J. Escarce. Cost Implications of ACGME’s 2011 Changes to Resident Duty Hours and the Training Environment. Journal of General Internal Medicine, 2011; DOI: 10.1007/s11606-011-1775-9

Cite This Page:

University of California - Los Angeles Health Sciences. "New limits on physician training hours could prove costly for US teaching hospitals." ScienceDaily. ScienceDaily, 8 September 2011. <www.sciencedaily.com/releases/2011/09/110908162153.htm>.
University of California - Los Angeles Health Sciences. (2011, September 8). New limits on physician training hours could prove costly for US teaching hospitals. ScienceDaily. Retrieved September 17, 2014 from www.sciencedaily.com/releases/2011/09/110908162153.htm
University of California - Los Angeles Health Sciences. "New limits on physician training hours could prove costly for US teaching hospitals." ScienceDaily. www.sciencedaily.com/releases/2011/09/110908162153.htm (accessed September 17, 2014).

Share This



More Health & Medicine News

Wednesday, September 17, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

President To Send 3,000 Military Personnel To Fight Ebola

President To Send 3,000 Military Personnel To Fight Ebola

Newsy (Sep. 16, 2014) — President Obama is expected to send 3,000 troops to West Africa as part of the effort to contain Ebola's spread. Video provided by Newsy
Powered by NewsLook.com
Man Floats for 31 Hours in Gulf Waters

Man Floats for 31 Hours in Gulf Waters

AP (Sep. 16, 2014) — A Texas man is lucky to be alive after he and three others floated for more than a day in the Gulf of Mexico when their boat sank during a fishing trip. (Sept. 16) Video provided by AP
Powered by NewsLook.com
Ivorians Abandon Monkey Pets in Fear Over Ebola Virus

Ivorians Abandon Monkey Pets in Fear Over Ebola Virus

AFP (Sep. 16, 2014) — Since the arrival of Ebola in Ivory Coast, Ivorians have been abandoning their pets, particularly monkeys, in the fear that they may transmit the virus. Duration: 00:47 Video provided by AFP
Powered by NewsLook.com
Study Links Male-Pattern Baldness To Prostate Cancer

Study Links Male-Pattern Baldness To Prostate Cancer

Newsy (Sep. 16, 2014) — New findings suggest men with a certain type of baldness at age 45 are 39 percent more likely to develop aggressive prostate cancer. Video provided by Newsy
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