Effect of 80-hour workweek on continuity of care.
Work limitations were mandated (2003) to increase safety and improve resident lifestyle. Is clinic continuity affected? Medical University of South Carolina pediatric residents' records for 6 months of 2002 (before regulation) and 2003 (after regulation) were reviewed. Continuity for physician formula, t tests, and multivariate linear regression were used. Continuity was calculated for 44 residents (2002) and 45 residents (2003). Mean continuity was 54% (2002) and 53% (2003; P = .5); continuity for well-child care visits was 78% (2002) and 73% (2003; P = .047). Continuity decreased most for interns (52% [2002], 47% [2003] for all visits; 76%, 67% for well-child care visits). In the multivariate model, year did not predict continuity. When only well-child care visits were considered, year showed a trend toward significance ( P = .07): 2003 had less continuity. Compared with third-year residents, interns had 8% points less continuity for all visits (6% points less for well-child care visits). Continuity can be maintained despite regulations. Interns are most vulnerable.
McBurney
Patricia G
PG
Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina 29425, USA. mcburnpg@musc.edu
Gustafson
Kristina K
KK
Darden
Paul M
PM
D003266:Continuity of Patient Care; D006801:Humans; D007396:Internship and Residency / Q000331:legislation & jurisprudence*; D016014:Linear Models; D010372:Pediatrics / Q000193:education*; D013022:South Carolina; D016526:Workload / Q000331:legislation & jurisprudence*