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IOM recommendations could cost teaching hospitals $3.2 million annually, study says

Residency Program Connection, May 26, 2009

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The cost of implementing the Institute of Medicine’s (IOM) resident work hour recommendations could be significantly more than originally stated in the IOM report, according to a new study published in the New England Journal of Medicine (NEJM).

The analysis stated that the $1.6 billion, estimated by the IOM, is based on 2006 dollars. The actual cost could range between $1.6 billion and $2.5 billion by today’s currency, said study researchers at the RAND Corporation and University of California, Los Angeles. The estimated costs to each teaching hospital would average about $3.2 million annually.

Researchers considered the various solutions hospitals may implement to cover resident workload if the IOM’s recommendations become requirements, including adding more residents or shifting the work to other healthcare workers, such as physician assistants. They looked at published data to determine approximate costs of each model.

"Adopting new restrictions on the work hours of physicians in training would impose a substantial new cost on the nation's 8,500 physician training programs," said lead author Dr. Teryl K. Nuckols, an internist at the David Geffen School of Medicine at UCLA and a researcher at RAND, a nonprofit research organization in a press release. "There is no obvious way to pay for these changes so that's one major issue that must be addressed."

Because hospitals may choose any number of ways to cover residents’ workload, it was difficult for researchers to ascertain what the impact will be on patient safety.

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