Adjusted association between increasing weekly work hours and adverse health and safety outcomes among PGY2+ resident physicians
| Outcome | Weekly work hours | P value | ||||
| ≤48 | >48 and ≤60 | >60 and ≤70 | >70 and ≤80 | >80 | ||
| Patient safety | ||||||
| Medical errors | Reference | 1.61 (1.39 to 1.87) | 2.36 (2.01 to 2.78) | 3.19 (2.69 to 3.78) | 4.01 (3.32 to 4.84) | <0.001 |
| Preventable adverse events | Reference | 1.54 (1.06 to 2.24) | 2.93 (2.04 to 4.23) | 2.84 (1.93 to 4.19) | 3.84 (2.51 to 5.87) | <0.001 |
| Fatal preventable adverse events | Reference | 0.66 (0.25 to 1.70) | 2.75 (1.23 to 6.12) | 2.51 (0.87 to 5.30) | 3.67 (1.45 to 9.30) | <0.001 |
| Resident safety | ||||||
| Motor vehicle crashes | Reference | 0.93 (0.74 to 1.19) | 0.99 (0.76 to 1.28) | 0.94 (0.72 to 1.24) | 1.24 (0.92 to 1.66) | 0.49 |
| Crashes leaving work | Reference | 0.96 (0.66 to 1.41) | 0.96 (0.62 to 1.47) | 0.92 (0.59 to 1.43) | 1.78 (1.15 to 2.76) | 0.13 |
| Near miss crashes | Reference | 1.41 (1.23 to 1.61) | 1.77 (1.52 to 2.06) | 2.11 (1.81 to 2.46) | 2.97 (2.52 to 3.50) | <0.001 |
| Occupational exposures | Reference | 1.78 (1.48 to 2.16) | 2.46 (2.03 to 2.98) | 3.35 (2.77 to 4.06) | 4.19 (3.39 to 5.17) | <0.001 |
| Percutaneous injuries | Reference | 1.71 (1.28 to 2.28) | 2.59 (1.95 to 3.44) | 3.49 (2.62 to 4.64) | 5.80 (4.32 to 7.79) | <0.001 |
| Attentional failures | Reference | 1.33 (1.27 to 1.40) | 1.80 (1.69 to 1.92) | 2.29 (2.13 to 2.46) | 3.06 (2.85 to 3.30) | <0.001 |
All models are adjusted for age, gender, specialty, and cohort. Occupational exposures, percutaneous injuries, and patient safety outcomes are further adjusted for hours in patient care. P values are obtained from likelihood ratio tests testing a linear trend through the categories. Estimates for near miss crashes and attentional failures are incidence rate ratios (95% confidence intervals); all other estimates are odds ratios (95% confidence intervals). PGY2+ residents=resident physicians at postgraduate year 2 and above.