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医生长时间工作与不良事件严重程度之间的关联:一项使用日本国家不良事件报告系统数据的横断面研究。

Association between long working hours of doctors and the seriousness of adverse events: a cross-sectional study using national adverse event reporting system data in Japan.

作者信息

Arai Yumi, Kachi Yuko, Hikichi Hiroyuki, Watanabe Kazuhiro, Inoue Reiko, Iwata Noboru, Tsutsumi Akizumi

机构信息

Graduate School of Medical Sciences, Kitasato University, Japan.

Department of Public Health, School of Medicine, Kitasato University, Japan.

出版信息

Ind Health. 2025 Apr 1;63(2):156-163. doi: 10.2486/indhealth.2023-0125. Epub 2024 Aug 12.

Abstract

The association between doctors' long working hours and the seriousness of adverse events with high patient impact has not been fully confirmed. Most previous studies were based on work hour regulations using more than 80 h per week as an indicator of long working hours. We aimed to assess the association using a shorter indicator as the cut-off for long working hours among hospital doctors including senior doctors. This cross-sectional study used 12,245 adverse event reports from the Japan Council for Quality Health Care. We defined long working hours as 55 h or more in the week before the adverse event and assessed the association with the seriousness of adverse events with high patient impact. The results showed that doctors working 55 or more hours in the preceding week were more likely to be involved in serious adverse events than those working fewer hours (odds ratio (OR) 1.22, 95% confidence interval (CI): 1.12-1.32). This association remained significant after adjusting for all covariates (OR 1.18, 95% CI: 1.08-1.28). Senior doctors were more likely to be involved in serious adverse events. Long working hours among doctors were associated with the seriousness of adverse events.

摘要

医生长时间工作与对患者产生重大影响的不良事件的严重程度之间的关联尚未得到充分证实。以往大多数研究基于工作时间规定,将每周工作超过80小时作为长时间工作的指标。我们旨在使用更短的指标作为包括资深医生在内的医院医生长时间工作的临界值来评估这种关联。这项横断面研究使用了来自日本医疗质量理事会的12245份不良事件报告。我们将长时间工作定义为不良事件发生前一周工作55小时或更长时间,并评估其与对患者产生重大影响的不良事件严重程度的关联。结果显示,前一周工作55小时或更长时间的医生比工作时间较短的医生更有可能卷入严重不良事件(优势比(OR)1.22,95%置信区间(CI):1.12 - 1.32)。在对所有协变量进行调整后,这种关联仍然显著(OR 1.18,95% CI:1.08 - 1.28)。资深医生更有可能卷入严重不良事件。医生长时间工作与不良事件的严重程度相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d697/11995148/b1152df264b6/indhealth-63-156-g001.jpg

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