Work-Hour Restrictions Have Not Improved Outcomes

TUESDAY, Dec. 9, 2014 (HealthDay News) -- Reducing medical residents' work hours hasn't improved mortality rates, hospital readmission rates, or outcomes of surgery, according to two new studies published in the Dec. 10 issue of the Journal of the American Medical Association, a theme issue on medical education.

In the first study, a team led by Mitesh Patel, M.D., M.B.A., an assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine in Philadelphia, found that the 2011 reforms hadn't reduced mortality or readmissions or improved patient safety among hospitalized Medicare patients. To reach these conclusions, Patel's group analyzed Medicare data on more than six million admissions at 3,104 hospitals. The admissions were for conditions such as myocardial infarction, stroke, gastrointestinal bleeding, or congestive heart failure, or conditions requiring general, orthopedic, or vascular surgery.

In the second study, Karl Bilimoria, M.D., an assistant professor of surgery at the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined general surgery outcomes of 204,641 patients from 23 teaching and 31 non-teaching hospitals. They looked at the two years before and two years after the 2011 reform. The researchers found that the 2011 reforms did not result in significant changes in the rates of mortality or serious illness in general surgery patients during the first two years after the reforms were in place. On the plus side, the study found that resident test scores and scores on medical board exams did not change significantly from 2010 to 2013.

"The work-hour restrictions have been controversial because there have been questions whether they are positive or negative," James Arrighi, M.D., an associate professor of medicine at Brown University in Providence, R.I., told HealthDay. Arrighi is also the coauthor of an accompanying editorial.

Abstract - Patel
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Abstract - Bilimoria
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Editorial (subscription or payment may be required)