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文书工作负担与电子环境特征与医生倦怠和职业满意度的关系。

Relationship Between Clerical Burden and Characteristics of the Electronic Environment With Physician Burnout and Professional Satisfaction.

机构信息

Division of Hematology, Mayo Clinic, Rochester, MN.

Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN.

出版信息

Mayo Clin Proc. 2016 Jul;91(7):836-48. doi: 10.1016/j.mayocp.2016.05.007. Epub 2016 Jun 27.

Abstract

OBJECTIVE

To evaluate associations between the electronic environment, clerical burden, and burnout in US physicians.

PARTICIPANTS AND METHODS

Physicians across all specialties in the United States were surveyed between August and October 2014. Physicians provided information regarding use of electronic health records (EHRs), computerized physician order entry (CPOE), and electronic patient portals. Burnout was measured using validated metrics.

RESULTS

Of 6375 responding physicians in active practice, 5389 (84.5%) reported that they used EHRs. Of 5892 physicians who indicated that CPOE was relevant to their specialty, 4858 (82.5%) reported using CPOE. Physicians who used EHRs and CPOE had lower satisfaction with the amount of time spent on clerical tasks and higher rates of burnout on univariate analysis. On multivariable analysis, physicians who used EHRs (odds ratio [OR]=0.67; 95% CI, 0.57-0.79; P<.001) or CPOE (OR=0.72; 95% CI, 0.62-0.84; P<.001) were less likely to be satisfied with the amount of time spent on clerical tasks after adjusting for age, sex, specialty, practice setting, and hours worked per week. Use of CPOE was also associated with a higher risk of burnout after adjusting for these same factors (OR=1.29; 95% CI, 1.12-1.48; P<.001). Use of EHRs was not associated with burnout in adjusted models controlling for CPOE and other factors.

CONCLUSION

In this large national study, physicians' satisfaction with their EHRs and CPOE was generally low. Physicians who used EHRs and CPOE were less satisfied with the amount of time spent on clerical tasks and were at higher risk for professional burnout.

摘要

目的

评估美国医生的电子环境、文书工作负担与倦怠之间的关系。

参与者和方法

2014 年 8 月至 10 月期间,对美国所有专业的医生进行了调查。医生提供了有关电子病历(EHRs)、计算机化医嘱录入(CPOE)和电子患者门户使用情况的信息。使用经过验证的指标衡量倦怠情况。

结果

在 6375 名活跃执业的应答医生中,有 5389 名(84.5%)报告他们使用 EHRs。在表示 CPOE 与他们的专业相关的 5892 名医生中,有 4858 名(82.5%)报告使用了 CPOE。在单变量分析中,使用 EHRs 和 CPOE 的医生对花在文书工作上的时间的满意度较低,倦怠率较高。在多变量分析中,调整年龄、性别、专业、实践环境和每周工作小时数后,使用 EHRs(比值比 [OR] = 0.67;95%置信区间 [CI],0.57-0.79;P<.001)或 CPOE(OR = 0.72;95% CI,0.62-0.84;P<.001)的医生不太可能对花在文书工作上的时间感到满意。调整了这些相同因素后,使用 CPOE 与倦怠风险增加相关(OR = 1.29;95% CI,1.12-1.48;P<.001)。在调整模型中控制 CPOE 和其他因素后,使用 EHRs 与倦怠无关。

结论

在这项大型全国性研究中,医生对他们的 EHRs 和 CPOE 的满意度普遍较低。使用 EHRs 和 CPOE 的医生对花在文书工作上的时间的满意度较低,并且倦怠的风险较高。

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