title: Exposing physicians to reduced residency work hours did not adversely affect patient outcomes after residency.
abstract: In 2003, work hours for physicians-in-training (residents) were capped by regulation at eighty hours per week, leading to the hotly debated but unexplored issue of whether physicians today are less well trained as a result of these work-hour reforms. Using a unique database of nearly all hospitalizations in Florida during 2000-09 that were linked to detailed information on the medical training history of the physician of record for each hospitalization, we studied whether hospital mortality and patients' length-of-stay varied according to the number of years a physician was exposed to the 2003 duty-hour regulations during his or her residency. We examined this database of practicing Florida physicians, using a difference-in-differences analysis that compared trends in outcomes of junior physicians (those with one-year post-residency experience) pre- and post-2003 to a control group of senior physicians (those with ten or more years of post-residency experience) who were not exposed to these reforms during their residency. We found that the duty-hour reforms did not adversely affect hospital mortality and length-of-stay of patients cared for by new attending physicians who were partly or fully exposed to reduced duty hours during their own residency. However, assessment of the impact of the duty-hour reforms on other clinical outcomes is needed.
authors.affiliation: Anupam B. Jena (jena@hcp.med.harvard.edu) is an assistant professor of health care policy and medicine at Harvard Medical School and a physician at Massachusetts General Hospital, both in Boston; and a faculty research fellow at the National Bureau of Economic Research, in Cambridge, Massachusetts.
authors.forename: Anupam B
authors.initials: AB
authors.lastname: Jena
authors.affiliation: Lena Schoemaker is a research assistant at the Center for Primary Care and Outcomes Research at Stanford University, in California.
authors.forename: Lena
authors.initials: L
authors.lastname: Schoemaker
authors.affiliation: Jay Bhattacharya is an associate professor at the Center for Primary Care and Outcomes Research at Stanford University and a research associate at the National Bureau of Economic Research.
authors.forename: Jay
authors.initials: J
authors.lastname: Bhattacharya
mesh_terms: D005431:Florida; D006761:Hospitals; D006801:Humans; D007396:Internship and Residency / Q000592:standards / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome; D000078329:Workforce
keywords: Health Professions Education; Hospitals; Workforce Issues