New resident duty hours to cost teaching hospitals $1.3B

It's been more than two months since the Accreditation Council for Graduate Medical Education (ACGME) shortened resident shifts to 16 hours, with the hope of improving patient safety. Yet that improvement comes with a hefty price tag: U.S teaching hospitals will have to spend up to $1.3 billion a year to implement the new limits, concludes a new University of California Los Angeles (UCLA) study.

The associated costs of carrying out the duty-hour limits include educating residents and faculty members about fatigue and patient safety, standardizing the process of increasing resident autonomy, regulating patient handoffs, providing transportation or sleep facilities after extended shifts, and setting up annual site visits by the ACGME, according to the study published in the Journal of General Internal Medicine.

With reduced reimbursements and a still sluggish economy keeping patient volume down, some hospitals might not be able to afford to make those changes.

For example, teaching hospitals will have to come up with $177 million annually nationwide, based on the most optimistic cost estimates, or up to $982 million, based on less optimistic valuations, notes a UCLA press release. Hospitals also will have to supply an additional $204 million annually nationwide to amend their training processes.

What's more, the study authors note that unless medical errors drop by at least 7.2 percent to 25.8 percent--depending on implementation costs--teaching hospitals will lose money from the duty-hour changes. The changes can be considered relatively cost-effective if errors drop by 3 percent.

The study highlights that teaching hospitals may be in a tough position as they face mounting pressure to both cut costs and improve care.

For more:
- read the press release
- check out the study abstract
- read the ACGME Common Program Requirements (.pdf)

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