Physician work-hours Work hours Over 60 hours a week On call residents could work up to 3o consecutive hours In 2003,implementation to limit number of hours/week for US doctors No more than 80 hours a week No change in patient mortality Many residents still work over 80 hours a week,but report only 80 hours Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Physician work-hours Work hours Over 60 hours a week On call residents could work up to 30 consecutive hours In 2003, implementation to limit number of hours/week for US doctors No more than 80 hours a week No change in patient mortality Many residents still work over 80 hours a week, but report only 80 hours
Work-hour tradeoffs ▣Longer work-hours Fatigue may impair physicians'cognitive abilities and in turn may affect patient health Shorter work-hours Requires more hand-offs by physicians and thus greater chance for error Empirical question which effect dominates Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Work-hour tradeoffs Longer work-hours Fatigue may impair physicians’ cognitive abilities and in turn may affect patient health Shorter work-hours Requires more hand-offs by physicians and thus greater chance for error Empirical question which effect dominates
Shorter hours leads to fewer errors Randomized experiment at Brigham and Woman's ICU at Harvard (2004) 2 groups:traditional hours(8o hours/week)&short work week (60 hours/week) Traditional hour group Committed 36%more serious medical errors 21%more medication errors 5.6 times more diagnostic errors Senior physicians intercepted most serious errors Bhattacharya,Hyde and Tu-HealthEconomics
Bhattacharya, Hyde and Tu – Health Economics Shorter hours leads to fewer errors Randomized experiment at Brigham and Woman’s ICU at Harvard (2004) 2 groups: traditional hours (80 hours/week) & short work week (60 hours/week) Traditional hour group Committed 36% more serious medical errors 21% more medication errors 5.6 times more diagnostic errors Senior physicians intercepted most serious errors
Returns to medical training
Returns to medical training