Thorpe K E
Department of Health Policy and Management, Harvard University School of Public Health, Boston, Mass. 02115.
JAMA. 1990 Jun 20;263(23):3177-81.
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.
1989年7月，纽约州通过了新规定，限制住院医生的工作时长，并要求对初级住院医生进行持续的现场监督。此外，纽约州的所有医院都必须提供24小时的静脉输液、静脉穿刺抽血以及信使/运输服务。本文探讨了纽约州这些具有里程碑意义的变革对医院人员配备、毕业后医学教育、辅助人员需求以及医院支出的影响。基于一项全州范围的调查，结果表明，实施这些规定将要求医院额外雇佣5358名全职等效人员，每年成本将超过3.58亿美元。本文还探讨了这些规定对研究生培训资金的更广泛影响。
