Lawrence P. Casalino (
Jing Li, Weill Cornell Medical College.
Health Aff (Millwood). 2022 Apr;41(4):549-556. doi: 10.1377/hlthaff.2021.00440.
Despite reports of a physician burnout epidemic, there is little research on the relationship between burnout and objective measures of care outcomes and no research on the relationship between burnout and costs of care. Linking survey data from 1,064 family physicians to Medicare claims, we found no consistent statistically significant relationship between seven categories of self-reported burnout and measures of ambulatory care-sensitive admissions, ambulatory care-sensitive emergency department visits, readmissions, or costs. The coefficients for ambulatory care-sensitive admissions and readmissions for all burnout levels, compared with never being burned out, were consistently negative (fewer ambulatory care-sensitive admissions and readmissions), suggesting that, counterintuitively, physicians who report burnout may nevertheless be able to create better outcomes for their patients. Even if true, this hypothesis should not indicate that physician burnout is beneficial or that efforts to reduce physician burnout are unimportant. Our findings suggest that the relationship between burnout and outcomes is complex and requires further investigation.
尽管有报道称医生职业倦怠现象严重,但关于倦怠与护理结果的客观衡量指标之间的关系的研究甚少,也没有研究关注倦怠与护理成本之间的关系。我们将 1064 名家庭医生的调查数据与医疗保险索赔数据相关联,结果发现,自我报告的倦怠的七个类别与门诊护理敏感入院、门诊护理敏感急诊就诊、再入院或成本之间没有一致的统计学显著关系。与从未倦怠相比,所有倦怠水平的门诊护理敏感入院和再入院的系数均为负(门诊护理敏感入院和再入院人数减少),这表明,具有讽刺意味的是,报告倦怠的医生可能仍然能够为患者创造更好的结果。即使这是真的,这一假设也不应表明医生职业倦怠是有益的,或者减轻医生职业倦怠的努力不重要。我们的研究结果表明,倦怠与结果之间的关系很复杂,需要进一步调查。