In VA Hospitals, Reduced Hours Yield Reduced Mortality

Volpp, et. al. “Mortality Among Patients in VA Hospitals in the First 2 Years Following ACGME Resident Duty Hour Reform.” JAMA, 2007;298(9):984-992. (Download in PDF.)

The tighter work hour regulations that were instituted by the ACGME in July 2003 have reduced mortality rates for patients admitted to VA hospitals, according to a study published in the September 5, 2007 edition of the Journal of the American Medical Association. The researchers looked at mortality data from 2001 to 2005 on patients admitted to “teaching intensive” VA hospitals with the diagnoses of four common medical conditions: stroke, congestive heart failure, acute myocardial infarction, and gastrointestinal bleeding. Parallel data from non-teaching intensive VA hospitals were examined as a control.

“It has been argued that duty hour reform would improve outcomes by reducing resident fatigue, although other studies have suggested that decreased continuity of care would worsen outcomes,” the researchers write in the article. “Our results suggest significant relative improvements in mortality rates for patients with 4 common, high-mortality medical conditions in more teaching-intensive VA hospitals following implementation of the duty hour rules.”