Stanford Medicine, Stanford, CA; The Risk Authority, Columbia, SC.
Stanford University School of Medicine, Stanford, CA.
Mayo Clin Proc. 2020 Apr;95(4):719-726. doi: 10.1016/j.mayocp.2019.09.025.
To study the relationship between occupational distress and sleep-related impairment in physicians and unsolicited patient complaints.
We used deidentified data from an academic medical center's physician survey administered in April and May of 2013 to perform a retrospective cohort study. Third-party stewards of the identifiable information regarding unsolicited patient complaints from January 1, 2013, through December 31, 2016, matched these data with corresponding physicians' occupational distress data. Unsolicited patient complaints were used to calculate the Patient Advocacy Reporting System (PARS) score, a validated predictor of malpractice litigation risk and clinical outcomes. Physicians were grouped into 1 of 3 PARS risk categories based on previously defined thresholds: low risk (score of 0), intermediate risk (score of 1-12), or high risk (score ≥13).
Each 1-point increase in burnout and sleep-related impairment, on a 5-point scale, was associated with a 69% (odds ratio [OR], 1.69; 95% CI, 1.12-2.54) and 49% (OR, 1.49; 95% CI, 1.08-2.05) increased odds of being in the next higher PARS risk category, respectively, averaged across all 4 years. Professional fulfillment was a protective factor, associated with fewer unsolicited patient complaints. Each 1-point decrease in professional fulfillment was associated with a 68% (OR, 1.68; 95% CI, 1.16-2.44) increased odds of being in the next higher PARS risk category. The effect of depression on PARS risk category was not significant (OR, 1.33; 95% CI, 0.84-2.10).
Findings from this research suggest that occupational distress and sleep-related impairment in physicians are associated with unsolicited patient complaints.
研究医生职业困扰与睡眠相关损害以及患者非自愿投诉之间的关系。
我们使用 2013 年 4 月至 5 月间一家学术医疗中心的医生调查中的匿名数据，进行回顾性队列研究。第三方托管者获取了 2013 年 1 月 1 日至 2016 年 12 月 31 日期间的患者非自愿投诉相关的可识别信息，并将这些数据与相应医生的职业困扰数据相匹配。患者非自愿投诉被用来计算患者倡导报告系统（PARS）评分，该评分是医疗事故诉讼风险和临床结果的有效预测指标。医生根据先前定义的阈值被分为 3 个 PARS 风险类别之一：低风险（得分为 0）、中风险（得分为 1-12）或高风险（得分为≥13）。
在 5 分制中，职业倦怠和睡眠相关损害每增加 1 分，分别与下一个更高的 PARS 风险类别相关的几率增加 69%（比值比[OR]，1.69；95%置信区间[CI]，1.12-2.54）和 49%（OR，1.49；95%CI，1.08-2.05），这是在所有 4 年的平均值。专业满意度是一个保护因素，与较少的患者非自愿投诉相关。专业满意度每降低 1 分，与下一个更高的 PARS 风险类别相关的几率增加 68%（OR，1.68；95%CI，1.16-2.44）。抑郁对 PARS 风险类别的影响不显著（OR，1.33；95%CI，0.84-2.10）。
这项研究的结果表明，医生的职业困扰和睡眠相关损害与患者非自愿投诉有关。
