Cost Implications of Reduced Work Hours and Workloads for Resident Physicians

Nuckols, Teryl K.; Bhattacharya, Jay; Wolman, Dianne Miller; Ulmer, Cheryl; Escarce, José J.

doi:10.1097/01.ogx.0000359271.14349.c3

Cited by 12 publications

(12 citation statements)

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“…This would be equivalent to adding an additional 8247 residency positions across all specialties. [8][9][10] While the ACGME's new mandated changes are different than the IOM's recommendations, they will also restrict resident duty hours that we believe could lead to gaps in patient care requiring significant personnel changes in the healthcare system.…”

Section: Figmentioning

confidence: 96%

Inpatient staffing within pediatric residency programs: Work hour restrictions and the evolving role of the pediatric hospitalist

Oshimura¹,

Sperring²,

Bauer³

et al. 2011

Journal of Hospital Medicine

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OBJECTIVE:In October 2010, the Accreditation Council for Graduate Medical Education (ACGME) mandated new standards that will further restrict resident work hours. There is growing concern surrounding the impact these restrictions will have on the staffing of inpatient services. The objective of this study was to survey the landscape of pediatric resident coverage of noncritical care inpatient teaching services prior to the implementation of these guidelines. In addition, we sought to explore how changes in work hour restrictions might affect the role of pediatric hospitalists in training programs.METHODS:In January 2010, an institutional review board (IRB)‐approved electronic survey was sent to 196 US residency training programs via the Association of Pediatric Program Directors (APPD) listserve.RESULTS:One hundred twenty responses were received representing 5201 pediatric residents. Of the programs that responded, 84% have hospitalists. At programs with hospitalists (n = 97), 24% have pediatric hospitalist attendings in‐house at night. Nearly a quarter of responding programs (22%) reported having no attending physicians in‐house at night. At the time of our survey, 31% of programs anticipated the addition of 24‐hour in‐house hospitalist coverage within the next 5 years. When the additional work hour restrictions are implemented, 70% of programs anticipated the need to add additional hospitalist coverage at night.CONCLUSIONS:Significant variation exists in how pediatric teaching services provide overnight coverage. While hospitalists are prevalent in pediatric training programs (84% overall, 67% day only), their role in direct patient care during the overnight hours has been limited thus far. New work hour restrictions will promote the need for more hospitalists. Journal of Hospital Medicine 2012;. © 2011 Society of Hospital Medicine.

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Section: Figmentioning

confidence: 96%

Inpatient staffing within pediatric residency programs: Work hour restrictions and the evolving role of the pediatric hospitalist

Oshimura¹,

Sperring²,

Bauer³

et al. 2011

Journal of Hospital Medicine

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“…Focusing on duty-hour limits, we previously estimated the cost of the IOM policies at $1.7 billion annually nationwide (inflated to 2008) 5 . In comparison, the 2011 duty-hour requirements would cost $177 million to $982 million.…”

Section: Discussionmentioning

confidence: 99%

“…We previously estimated the cost of the IOM duty-hour policies 5 , but the ACGME policies differ. In addition to informing the debate about duty-hour limits, examining the costs of different implementation approaches can facilitate planning and decision making by teaching institutions.…”

Section: Introductionmentioning

confidence: 99%

Cost Implications of ACGME’s 2011 Changes to Resident Duty Hours and the Training Environment

Nuckols

Escarce

2011

J GEN INTERN MED

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“…4 Anticipated issues related to their implementation include the influence of educational and logistical concerns on department hiring as well as varying financial implications for hospitals and residency programs. 3 Although previous studies estimate the financial burden on hospitals prior to implementation of changes, to the knowledge of the authors, there has been no retrospective evaluation of costs on the hospital or departmental level using primary data.…”

Section: Introductionmentioning

confidence: 99%

Impact of 2011 Resident Duty Hour Requirements on Neurology Residency Programs and Departments

George

Probasco

Dorsey

et al. 2014

The Neurohospitalist

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Objective: In 2011, the Accreditation Council on Graduate Medical Education (ACGME) redefined resident duty hour requirements by reducing in-hospital duty hour requirements for residents in an effort to improve patient care, resident wellbeing, and resident education. We sought to determine the cost of adoption based on changes made by neurology residency programs and departments due to these requirements. Methods: We surveyed department chairs or residency program directors at 123 ACGME-accredited US adult neurology training programs on programmatic changes and resident expansion, hiring practices, and development of new computer-based resources in direct response to the 2011 ACGME duty hour requirements. Using data from publicly available resources, we estimated respondents' financial cost of adoption. Results: In all, 63 responded (51% response rate); 76% were program directors. The most common changes implemented by programs were adding night float systems (n ¼ 31; 49%) and increasing faculty responsibility (n ¼ 26; 41%). In direct response to the requirements, 21 programs applied to ACGME for 40 additional residents, 29 of which were fully covered by institutional funds. In direct response to the requirements, nearly half of the departments (n ¼ 26) hired individuals for a total of 80 hires (or 64 full-time equivalents), most commonly mid-level practitioners. The total estimated cost to responding departments was US $12.7 million or US $201,000 per department annually. When projecting expenses of planned changes for the following year, costs increased to US $360,000 per department, with 5-year costs exceeding US $1 million. Conclusions: The most recent restriction on resident duty hours comes at substantial cost to neurology departments and residency programs.

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Cost Implications of Reduced Work Hours and Workloads for Resident Physicians

Cited by 12 publications

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Inpatient staffing within pediatric residency programs: Work hour restrictions and the evolving role of the pediatric hospitalist

Inpatient staffing within pediatric residency programs: Work hour restrictions and the evolving role of the pediatric hospitalist

Cost Implications of ACGME’s 2011 Changes to Resident Duty Hours and the Training Environment

Impact of 2011 Resident Duty Hour Requirements on Neurology Residency Programs and Departments

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