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Table 4 Summary of studies analysing the impacts on quality of patient care

From: Restricted duty hours for surgeons and impact on residents quality of life, education, and patient care: a literature review

Patient care      
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 _ _