Prolonged Hospital Stay and the Resident Duty Hour Rules of 2003
Bibliographic Data
| ID | 9104137 |
|---|---|
| Authors | Jeffrey H Silber (0000-0001-6415-7910, Boston University, corresponding author), Paul R Rosenbaum (0000-0003-0872-1403, University of Pennsylvania), Amy K Rosen (0000-0002-7539-7749, Boston University, corresponding author), Patrick S Romano (0000-0001-6749-3979, University of California, Davis), Kamal M F Itani (Boston University), Liyi Cen (0009-0003-8258-6737, University of Pennsylvania), Lanyu Mi (0000-0002-6779-4568, Boston University, corresponding author), Michael J Halenar (0000-0002-8703-3811, University of Pennsylvania), Orit Even-Shoshan, Orit Even‐Shoshan (Boston University, corresponding author), Kevin G Volpp (0000-0003-3389-6707, Boston University, corresponding author) |
| Year | 2009 |
| Volume | 47 |
| Issue | 12 |
| Pages | 1191-1200 |
| Publication date | 2009-12-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e3181adcbff |
| PMID | 19786912 |
| PMCID | PMC3279179 |
| OpenAlex | W2063051806 |
| Language | EN |
| Citations received | 2 |
| References cited | 23 |
BACKGROUND: Resident duty hour reforms of 2003 had the potential to create a major impact on the delivery of inpatient care. OBJECTIVE: We examine whether the reforms influenced the probability of a patient experiencing a prolonged hospital length of stay (PLOS), a measure reflecting either inefficiency of care or the development of complications that may slow the rate of discharge. RESEARCH DESIGN: Conditional logistic models to compare PLOS in more versus less teaching-intensive hospitals before and after the reform, adjusting for patient comorbidities, common time trends, and hospital site. SUBJECTS: Medicare (N = 6,059,015) and Veterans Affairs (VA) (N = 210,276) patients admitted for medical conditions (acute myocardial infarction, heart failure, stroke, or gastrointestinal bleeding) or surgical procedures (general, orthopedic, and vascular) from July 2000 to June 2005. MEASURES: Prolonged length of stay. RESULTS: Modeling all medical conditions together, the odds of prolonged stay in the first year post reform at more versus less teaching intensive hospitals was 1.01 (95% CI: 0.97-1.05) for Medicare and 1.07 (0.94-1.20) for the VA. Results were similarly negative in the second year post reform. For "combined surgery" the post year 1 odds ratios were 1.04 (0.98-1.09) and 0.94 (0.78-1.14) for Medicare and the VA respectively, and similarly unchanged in post year 2. Isolated increases in the probability of prolonged stay did occur for some vascular surgery procedures. CONCLUSIONS: Hospitals generally found ways to cope with duty hour reform without increasing the prevalence of prolonged hospital stays, a marker of either inefficient care or complications
Duty · Political science · Emergency Medicine · Enhanced Recovery After Surgery · Hospital Admissions and Outcomes · Medicine · Sleep and Work-Related Fatigue
| Citations per year | 0.12 |
|---|---|
| Citation span | 2009 - 2013 (5) |
| Highly cited | No |