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Resident Work-Hour Limits May Have Improved Mortality

Patient mortality rates are either unchanged or improved in the two years post-reform

TUESDAY, Sept. 4 (HealthDay News) -- Resident work-hour reform, implemented by the Accreditation Council for Graduate Medical Education in 2003, does not appear to have had a negative effect on patient outcomes and may actually have improved mortality rates, according to two studies published in the Sept. 5 issue of the Journal of the American Medical Association.

Kevin G. Volpp, M.D., Ph.D., of the Philadelphia Veterans Affairs Medical Center in Philadelphia, and colleagues studied two large groups of patients, including over 8.5 million hospitalized Medicare beneficiaries and 318,636 VA hospital in-patients. Logistic regression was used to compare mortality rates in hospitals that were more teaching-intensive versus less teaching-intensive (based on resident-to-bed ratios) before and after duty-hour reform (2000-2003 and 2003-2005, respectively).

In the Medicare cohort, the change did not affect mortality either way in the first two years after the reform's implementation. In the VA study, duty-hour reform was associated with an improved mortality rate for patients with four common, life-threatening medical conditions, including acute myocardial infarction, who were cared for in more teaching-intensive hospitals.

"Although this is an observational study and we cannot be certain that the reduction in mortality was caused by the reform, the findings are nonetheless reassuring," the authors write.

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