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Sticking to Work Hours Limits Very Costly

Benefits of adherence to recommended time limits not proven, study suggests

WEDNESDAY, May 20 (HealthDay News) -- Adherence to the 2003 Accreditation Council for Graduate Medical Education (ACGME) limits on work hours, and other measures aimed at reducing fatigue among residents, would be costly with no proven benefits, according to an article published in the May 21 issue of the New England Journal of Medicine.

Teryl K. Nuckols, M.D., of the David Geffen School of Medicine in Los Angeles, and colleagues analyzed published data to look at the cost of adherence to the 2003 ACGME limits, reduced workloads, napping during long shifts, and a 16-hour limit for shifts without naps. They calculated the cost of transferring work from residents to substitute providers and also the net costs to major teaching hospitals.

Implementing the recommendations would result in $1.6 billion in annual labor costs, the investigators found. When they looked at the cost of a 10 percent decrease to a 10 percent increase in preventable adverse events, they found net per admission costs for major teaching hospitals ranged from $99 to $183, and from $17 to $266 for society.

"If the changes were highly effective, they could prevent patient harm at reduced or no cost to society," the authors write. "However, financial incentives for teaching hospitals are not well aligned with the implementation of these reforms."

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