Patient care | Â | Â | Â | Â | Â |
---|---|---|---|---|---|
Improved | No Change | Worsen | |||
Source | Outcome | Source | Outcome | Source | Outcome |
Basu et al, 2004[14] A 68-item survey of plastic surgery residents (n = 12) | Residents noted an improved ability to deliver patient care, hight consensus that this policy is benefitial for patient care | Rogers et al, 2005[40] Pre-post study of complications, missed injuries, delayed diagnoses, and admission rates | No significant difference in the overall complication rate, delayed diagnoses, or missed injuries | Chung et al, 2004[15] Pre-post survey of surgical resident | The new regulation reduced continuity of care, reduced consultations seen |
_ | _ | Hutter et al, 2006[18] Prospective study of mortality, complication rates, NSQIP | No significan difference in quality of patient care, no differences in mortality rates | Kort et al, 2004[16] Survey of general surgery residents (n = 164) | Continuity and safety of care were perceived negatively by surgical residents |
_ | _ | Schneider et al, 2007 Pre-post evaluation of operative case logs, standardized scores, residents perception survey | Patient outcome measures, including monthly mortality and number of admissions showed no changes | Cohen-Gadol et al, 2005[29] Nationwide survey of program directors (n = 93) and residents (n = 617) | 93% thought that the new reform has had a negative impact on continuity of patient care. |
_ | _ | Shetty et al, 2007[37] Pre-post study of mortality rates in 551 community hospitals (n = 1.511.945 patients) | In surgical patients there were no significant changes of mortality rates | Myers et al, 2006[28] Pre-post survey of general surgery residents (n = 200) at 5 academic medical centers | Errors related to reduced continuity of care significantly increased. The continuity of care had decreased a lot. |
_ | _ | Volpp et al, 2007[38] Pre-post study of mortality rates in 3321 nonfederal hospitals (n = 8.529.595 patients) | The new reform was not associated with either significant worsening or improvements of mortality | _ | _ |
_ | _ | Morrison et al, 2008[39] Retrospective pre-post study of mortality, length of hospitalisation Data from NTDB | This analysis demonstrates slightly decreased mortality and morbidity rates. But more likely clinically not important | _ | _ |