Pazzaglia Silvia, Bruno Martina, Gambazza Simone, Binda Filippo, Bisesti Alberto, Calegari Jessica Graziella, Laquintana Dario
Department of Healthcare Professions, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Via Francesco Sforza 35, 20122, Milan, Italy.
Department of Clinical Sciences and Community Health, Dipartimento Di Eccellenza 2023-2027, Laboratory of Medical Statistics, Biometry and Epidemiology "G. A. Maccacaro", Università Degli Studi Di Milano, Via Celoria 22, 20133, Milan, Italy.
BMC Health Serv Res. 2025 Feb 20;25(1):286. doi: 10.1186/s12913-025-12430-4.
Reduced work capacity in public hospitals has organizational repercussions, given the aging population, the shortage of healthcare workers, and the greater demand for healthcare services. In this study, we analysed the characteristics of staff assessed as "fit with restrictions" at a public academic hospital in northern Italy. We also aimed to identify individual and work-related variables that may be associated with the probability and timing of being "fit with restrictions".
In this single-center observational study, sociodemographic data from staff employed in the Department of Healthcare Professions at our institution were analyzed using logistic regression to assess any associations between staff characteristics and the probability of being "fit with restrictions". Additionally, a multivariable Cox proportional hazard model was fitted to investigate the potential association between staff characteristics and the timing of their first assessment as "fit with restrictions".
The study population was 2251 employees of which 18.4% (415/2251) were "fit with restrictions"; 56.1% (233/415) of nursing staff had at least one restriction, whereas 72.3% (300/415) of staff with restrictions had a permanent restriction. Sex was not associated with the probability of being "fit with restrictions" (odds ratio [OR] 0.75, 95%CI: 0.55 to 1.03). However, the probability was 22.9% lower (95%CI: 14.1% to 31.8%) for rehabilitation and technical healthcare staff compared to that of nurses and midwives. The Cox model showed an increase in the hazards of being "fit with restrictions" by a factor of 1.30 (95%CI: 1.02-1.68) for females.
A significant proportion of nursing staff face mobility and posture restrictions, with older hires and greater seniority associated with higher probabilities of restrictions. These findings underscore the importance of addressing aging and workplace conditions in the public healthcare sector, particularly considering differences across job profiles and sex.
鉴于人口老龄化、医护人员短缺以及对医疗服务的需求增加，公立医院工作能力的下降会产生组织层面的影响。在本研究中，我们分析了意大利北部一家公立学术医院中被评估为“有受限健康状况”的员工的特征。我们还旨在确定可能与“有受限健康状况”的可能性和时间相关的个人及工作相关变量。
在这项单中心观察性研究中，我们使用逻辑回归分析了我们机构医疗保健专业部门员工的社会人口统计学数据，以评估员工特征与“有受限健康状况”可能性之间的任何关联。此外，我们拟合了一个多变量Cox比例风险模型，以研究员工特征与其首次被评估为“有受限健康状况”的时间之间的潜在关联。
研究人群为2251名员工，其中18.4%（415/2251）“有受限健康状况”；56.1%（233/415）的护理人员至少有一项限制，而72.3%（300/415）有受限健康状况的员工有永久性限制。性别与“有受限健康状况”的可能性无关（优势比[OR]为0.75，95%置信区间：0.55至1.03）。然而，与护士和助产士相比，康复和技术医疗保健人员“有受限健康状况”的可能性低22.9%（95%置信区间：14.1%至31.8%）。Cox模型显示，女性“有受限健康状况”的风险增加了1.30倍（95%置信区间：1.02 - 1.68）。
相当一部分护理人员面临行动和姿势限制，年龄较大的员工和资历较深的员工受限的可能性更高。这些发现强调了在公共医疗部门解决老龄化和工作场所条件问题的重要性，特别是考虑到不同工作岗位和性别的差异。
