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In July 2003, the US authorities limited working hours for medical residents in teaching hospitals. Since then, researchers have been trying to find out if the changes have been good or bad for patientspatients.
The data so far have been reassuring, says one editorial (p 1055). Of the three biggest studies looking at patient mortality, two reported slight improvements and one no change in the two years after the reforms. Limiting working hours seems to have done no overall harm to patients' chances of surviving a hospital admission. The two most recent studies examined death rates in high risk surgical and medical patients before and after the changes. Medicare patients admitted to general non-federal hospitals were unaffected, although there was a slight but measurable reduction in mortality among medical patients admitted to Veterans Affairs hospitals with a high commitment to teaching.
We still don't know for certain the effects of the reforms on medical costs, patient morbidity, or the risk of medical errors, and more work needs to be done, says the editorial. Whatever happens, the reforms are unlikely to be reversed because of the obvious benefits to US residents. They now work no more than 80 hours a week, and no more than 24 hours at a time.