Payette Michael, Chatterjee Abhishek, Weeks William B
School of Medicine, University of Connecticut, Farmington, CT, USA.
Am J Surg. 2009 Jun;197(6):820-5; discussion 826-7. doi: 10.1016/j.amjsurg.2008.05.013. Epub 2009 Apr 17.
Efforts to improve patient safety have attempted to incorporate aviation industry safety standards. We sought to evaluate the cost and workforce implications of applying aviation duty-hour restrictions to the entire practicing physician workforce.
The work hours and personnel deficit for United States residents and practicing physicians that would be created by the adoption of aviation standards were calculated.
Application of aviation standards to the resident workforce creates an estimated annual cost of $6.5 billion, requiring a 174% increase in the number of residents to meet the deficit. Its application to practicing physicians creates an additional annual cost of $80.4 billion, requiring a 71% increase in the physician workforce. Adding in the aviation industry's mandatory retirement age (65 years) increases annual costs by $10.5 billion. The cost per life-year saved would be $1,035,227.
Application of aviation duty-hour restrictions to the United States health care system would be prohibitively costly. Alternate approaches for improving patient safety are warranted.
为提高患者安全所做的努力试图纳入航空业安全标准。我们试图评估将航空值班时间限制应用于全体执业医师队伍所产生的成本和劳动力影响。
计算了采用航空标准后美国住院医师和执业医师的工作时间及人员短缺情况。
将航空标准应用于住院医师队伍估计每年成本为65亿美元，需要增加174%的住院医师数量以弥补短缺。将其应用于执业医师会额外产生每年804亿美元的成本，需要增加71%的医师队伍。加上航空业的强制退休年龄（65岁）会使年度成本增加105亿美元。每挽救一个生命年的成本将为1,035,227美元。
将航空值班时间限制应用于美国医疗保健系统成本过高。有必要采用其他提高患者安全的方法。
