House staff supervision and working hours. Implications of regulatory change in New York State
K. E. Thorpe
Department of Health Policy and Management, Harvard University School of Public Health, Boston, Mass. 02115.
In July 1989, New York State adopted new rules that limit the hours worked
by residents and mandate continuous, on-site supervision of junior
residents. In addition, all New York hospitals must provide 24-hour
coverage for intravenous, phlebotomy, and messenger/transporter services.
This article examines the impact of New York's landmark changes on hospital
staffing, graduate medical education, the demand for ancillary personnel,
and hospital expenditures. Based on a statewide survey, the results
indicate that implementation of these rules would require hospitals to hire
an additional 5358 full-time equivalent personnel at a yearly cost that
would exceed $358 million. The broader implications of these rules on
financing graduate training are also explored.
