The ACGME resident duty-hour restrictions were implemented in 2003 based on the belief that resident fatigue is a contributor to medical errors. The researchers examined the effect of duty-hour restrictions on outcomes for more than 222,000 admissions for neurosurgical trauma. Using the Nationwide Inpatient Sample database, researchers compared mortality and complications rates over a time period with no duty-hour restrictions (1999-2002) to one with restrictions (2005-2008). Both teaching and non-teaching hospitals were analyzed to account for any potential differences due to non-duty-hour-related factors.
Researchers found a significantly higher risk of complication with duty-hour restrictions at teaching hospitals, while there was no difference in complication rates at non-teaching hospitals. In teaching hospitals, there was no significant decrease in mortality rate between the two time periods, while in non-teaching hospitals, there was a significant improvement in mortality with hour restrictions. The researchers concluded the duty-hour restriction could impact complication rates at teaching hospitals.
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