Rested Resident Physicians: The effects of duty-hour reforms on all-cause-in-hospital mortality

Resident physicians are often overworked. Prior to 2003, over 87% of surgical residents
worked more than 80 hour work weeks (Niederee et al., 2003). With only 168 hours present in a
given week, residents were treating patients with limited sleep and rest. The increasing public
awareness of long resident work hours led to the Accreditation Council for Graduate Medical
Education (ACGME) formulating comprehensive duty hour regulations (Weinger &
Ancoli-Israel, 2002). In order to tackle the public concerns and to prevent national legislation,
the ACGME implemented new resident duty-hour regulations starting from July 1, 2003. A
major aspect of the regulation was an 80 hour work week limit averaged over four weeks for
residents (Weinger & Ancoli-Israel, 2002). This paper intends to measure the impact of the 2003
regulation on all cause mortality and over a slightly extended time period. Using National
Inpatient Survey data from 2000-2006, this paper uses a differences-in-differences linear
regression model to analyze the impact of the 2003 ACGME duty-hour reforms on all cause
inpatient mortality rates. This study finds that the 2003 ACGME duty-hour reforms did not have
a significant effect on all cause inpatient mortality rates. These results hold implications for
policies regarding resident duty-hours.