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Study: Fewer resident work hours don't reduce patient deaths

Quality Improvement Monitor, September 7, 2007

Reducing the number of hours of residents work does little to reduce patient deaths, according to two large studies reported in Newsday.

Those findings came from what the authors describe as the most comprehensive national look at work-hour restrictions, which were implemented four years ago in an effort to reduce medical errors by exhausted doctors-in-training, the paper said.

"We were a little surprised," Kevin Volpp, MD, PhD, the studies' lead author and a physician at the Philadelphia Veterans Affairs Medical Center, told Newsday. "We thought that mortality outcomes would improve more consistently."

The studies appear in Wednesday's Journal of the American Medical Association.

The new work-hour rules limit doctors-in-training to 80-hour weeks. Before the rules, residents often worked 100-hour weeks.

The two studies included 318,000 VA patients and more than 8.5 million Medicare patients at hospitals nationwide. Researchers looked at deaths within 30 days of hospital admission in the years before and after the rules went into effect in 2003, the paper reported.

Volpp told Newsday that one possible explanation is that more patient handoffs by residents offset the benefits of reduced fatigue.

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