School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Jingmen No. 2 People's Hospital, Jingmen, China.
Front Public Health. 2022 Apr 25;10:854772. doi: 10.3389/fpubh.2022.854772. eCollection 2022.
Physician dissatisfaction with more time spent on related paperwork but less time available for direct interaction with patients is increasing internationally. Increased physician workload resulting from paperwork might negatively affect their interaction with patients and increase the risk for burnout. This study aimed to investigate the level of physician workload tethered to paperwork during outpatient encounters and explore its latent workload subgroups among Chinese physicians.
A cross-sectional survey was conducted via online questionnaire primarily in 24 hospitals in 6 provinces in Eastern, Central, and Western China from November 2020 to February 2021. The Chinese physician mental workload scale developed by our research team was used for assessment of physician workload tethered to paperwork. Physicians were categorized into different subgroups of workload via latent profile analysis. Multinomial logistic regression was subsequently performed to examine how demographic variables differ among physicians belonging to different subgroups.
A total of 1,934 valid questionnaires were received. Chinese physicians reported medium levels of workload while performing non-physician-patient communication work tasks characterized by paperwork during outpatient encounters. Four latent workload subgroups were identified: "low workload group" (8.8%), "medium workload group" (34.0%), "high workload group" (42.1%) and "very high workload group" (15.1%). Compared with the other latent workload subgroups, physicians belonging to the "very high workload group" were more likely to be younger, married, those who had worse health status, lower educational levels and lower average monthly incomes, those who worked more years in the current institution, more hours per week and longer outpatient hours per week, and those who worked in public general hospitals, tertiary B hospitals and Obstetrics and Gynecology, and saw more than 50 outpatients per day, with more time spent on per patient.
There exit four latent workload subgroups among Chinese physicians tethered to paperwork during outpatient encounters along with great individual variations among these subgroups. The characteristics of the latent "very high workload group" can help permit more targeted guidance for developing interventions with optimized human resource allocation to, in turn, increase the time available for direct interaction with patients, thereby resulting in improved quality of physician-patient interactions and decreased risk for physician burnout.
国际上，医生对用于文书工作的时间增加但与患者直接交流的时间减少感到不满。文书工作导致的医生工作量增加可能会对他们与患者的互动产生负面影响，并增加倦怠的风险。本研究旨在调查门诊就诊期间与文书工作相关的医生工作量水平，并探索中国医生中潜在的工作量亚组。
2020 年 11 月至 2021 年 2 月，我们通过在线问卷主要在华东、华中、华西 6 个省的 24 家医院进行了一项横断面调查。使用我们研究团队开发的中文版医生心理工作量量表评估与文书工作相关的医生工作量。通过潜在剖面分析将医生分为不同的工作量亚组。随后进行多项逻辑回归，以检查不同亚组医生的人口统计学变量存在哪些差异。
共收到 1934 份有效问卷。中国医生在门诊就诊期间执行非医患沟通工作任务时，报告了中等水平的工作量，其特点是文书工作。确定了四个潜在的工作量亚组：“低工作量组”（8.8%）、“中工作量组”（34.0%）、“高工作量组”（42.1%）和“极高工作量组”（15.1%）。与其他潜在工作量亚组相比，属于“极高工作量组”的医生更年轻、已婚、健康状况更差、教育程度更低、平均月收入更低、在当前机构工作年限更长、每周工作时间更长、每周门诊时间更长、在公立医院、三级 B 医院和妇产科工作、每天看诊超过 50 人、每位患者花费的时间更多。
在中国医生门诊就诊期间，与文书工作相关的工作量存在四个潜在的工作量亚组，这些亚组之间存在很大的个体差异。潜在的“极高工作量组”的特点可以帮助有针对性地指导制定干预措施，优化人力资源配置，从而为直接与患者互动提供更多时间，进而提高医患互动的质量，降低医生倦怠的风险。
