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美国家庭医生职业倦怠的研究综述

Burnout Among Family Physicians in the United States: A Review of the Literature.

机构信息

D'Amore-McKim School of Business, Northeastern University, Boston, Massachusetts (Dr Hoff); School of Public Policy and Urban Affairs, Northeastern University, Boston, Massachusetts (Dr Hoff); Green-Templeton College, University of Oxford, Oxford, England, United Kingdom (Dr Hoff); Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts (Ms Trovato); and School of Public Policy and Urban Affairs, Northeastern University, Boston, Massachusetts (Ms Kitsakos).

出版信息

Qual Manag Health Care. 2024;33(1):1-11. doi: 10.1097/QMH.0000000000000439. Epub 2023 Oct 11.

Abstract

BACKGROUND AND OBJECTIVES

Burnout among physicians who work in primary care is an important problem that impacts health care quality, local communities, and the public's health. It can degrade the quality of primary care services in an area and exacerbate workforce shortages. This study conducted a review of the published research on burnout among family physicians working in the United States.

METHODS

We used a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided approach and several article databases to identify, filter, and analyze published research on US family physician burnout that uses data collected from 2015 onward.

RESULTS

Thirty-three empirical studies were identified with findings that included US family physician burnout prevalence and/or associations between burnout and specific personal and contextual drivers. Mean family physician burnout prevalence across studies that measured it was 35%. Almost half of the studies classified one-third or more of their family physician samples as burned out. Physician gender (being female), age (being younger), and job/work-related factors (workload, time pressures) were the most commonly identified correlates of family physician burnout. The vast majority of studies were cross-sectional and used secondary data.

CONCLUSIONS

The extant research literature on family physician burnout in the United States shows that burnout is currently a meaningful problem. Several important correlates of the problem can be identified, some of which managers and health care organizations can proactively address. Other correlates require managers and health care organizations also viewing family physicians in differentiated ways. The collective literature can be improved through a more consistent focus on similar burnout correlates across studies; inclusion of interventions aimed at lessening the effects of key burnout correlates; employment of more robust longitudinal and quasi-experimental research designs; and additional pandemic-era data collection on burnout.

摘要

背景与目的

初级保健医生的倦怠是一个重要问题,会影响医疗质量、当地社区和公众健康。它会降低该地区初级保健服务的质量,并加剧劳动力短缺。本研究对美国家庭医生倦怠的已发表研究进行了综述。

方法

我们使用了基于首选报告项目的系统评价和荟萃分析(PRISMA)方法和多个文章数据库,以确定、筛选和分析使用 2015 年以后收集的数据的关于美国家庭医生倦怠的已发表研究。

结果

确定了 33 项实证研究,这些研究的结果包括美国家庭医生倦怠的流行率以及倦怠与特定个人和背景驱动因素之间的关联。对其进行测量的研究中,家庭医生倦怠的平均流行率为 35%。几乎一半的研究将其三分之一或更多的家庭医生样本归类为倦怠。医生的性别(女性)、年龄(年轻)和工作/工作相关因素(工作量、时间压力)是家庭医生倦怠最常被确定的相关因素。绝大多数研究都是横断面研究,并使用了二级数据。

结论

美国关于家庭医生倦怠的现有研究文献表明,倦怠目前是一个有意义的问题。可以确定一些问题的重要相关因素,其中一些因素可以由管理人员和医疗保健组织主动解决。其他相关因素要求管理人员和医疗保健组织以不同的方式看待家庭医生。通过在研究中更一致地关注类似的倦怠相关因素、纳入旨在减轻关键倦怠相关因素影响的干预措施、采用更强大的纵向和准实验研究设计以及在大流行时期收集更多关于倦怠的数据,可以改进集体文献。

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