Mohr David C, Elnahal Shereef, Marks Maureen L, Derickson Ryan, Osatuke Katerine
National Center for Organization Development, Veterans Health Administration, Mason, Ohio.
Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, Massachusetts.
JAMA Netw Open. 2025 Apr 1;8(4):e255954. doi: 10.1001/jamanetworkopen.2025.5954.
Burnout among health care workers is a widespread concern in health care both before and since the COVID-19 pandemic, yet little is known about health care workers' burnout levels across occupations and settings.
To examine trends in burnout and professional stress reported among health care workers working at the US Veterans Health Administration (VHA) and identify occupations that experienced notable changes and the factors associated with changes.
DESIGN, SETTING, AND PARTICIPANTS: This survey study used a retrospective cohort design grouped by key factors associated with burnout and professional stress. Responses to an annual organization-wide survey at 140 medical centers from 2018 to 2023 were used.
Respondents self-reported on 2 burnout items (ie, "I feel burned out from my work" and "I worry that this job is hardening me emotionally") from the Maslach Burnout Inventory during all study years and professional stress (moderate or lower vs high or extreme) from COVID-19 from 2020 to 2023.
Trends by occupation, telework status, and geographic region were examined, as well as the general pattern over time and the change in burnout and stress rates in the years following the start of the pandemic.
In 2018, the sample was 71.6% female, with an estimated mean (SD) age of 46.31 (12.11) years, and estimated mean (SD) VA tenure of 8.54 (7.33) years. Totals of health care worker respondents identified from 140 medical centers ranged from 123 271 in 2018 to 169 448 in 2023. Annual burnout rates were 30.4% for 2018, 31.3% for 2019, 30.9% for 2020, 35.4% for 2021, 39.8% for 2022, and 35.4% for 2023. Rates of professional stress from COVID-19 were 32.0% for 2020, 26.9% for 2021, 29.2% for 2022, and 21.4% for 2023. Both measures showed a decrease following the official public health emergency ending in 2023. Primary care physicians reported the highest burnout levels compared with other service areas, ranging from 46.2% in 2018 to 57.6% in 2022. Several service areas saw a relative increase of 10% or more in burnout between 2018 and 2023, with mental health, dental, and rehabilitation service employees reporting the highest increases in burnout rates over this time. Burnout levels for respondents who teleworked most of the time were lower than those for respondents who did not telework.
In this survey study of VHA health care workers, burnout and professional stress decreased on average following the pandemic, but burnout levels remain elevated compared with prepandemic levels. The VHA has made several efforts to reduce burnout and stress, and results showed some promise, but exploration of ways to reduce burnout to prepandemic levels is needed.
医护人员的职业倦怠是新冠疫情之前及之后医疗保健领域普遍关注的问题，但对于不同职业和工作环境中医护人员的职业倦怠程度，我们知之甚少。
研究美国退伍军人健康管理局（VHA）医护人员报告的职业倦怠和职业压力趋势，确定经历显著变化的职业以及与这些变化相关的因素。
设计、背景和参与者：这项调查研究采用回顾性队列设计，按与职业倦怠和职业压力相关的关键因素进行分组。使用了2018年至2023年期间140个医疗中心每年组织范围内的调查回复。
在所有研究年份中，受访者根据马氏职业倦怠量表自行报告2个职业倦怠项目（即“我感觉工作让我精疲力竭”和“我担心这份工作正在使我在情感上变得冷酷无情”），以及2020年至2023年期间因新冠疫情产生的职业压力（中度或以下与高度或极端）。
研究了按职业、远程工作状态和地理区域划分的趋势，以及随时间的总体模式，以及疫情开始后几年中职业倦怠和压力率的变化。
2018年，样本中女性占71.6%，估计平均（标准差）年龄为46.31（12.11）岁，在退伍军人健康管理局的估计平均（标准差）任职年限为8.54（7.33）年。从140个医疗中心确定的医护人员受访者总数从2018年的123271人到2023年的169448人不等。2018年的年度职业倦怠率为30.4%，2019年为31.3%，2020年为30.9%，2021年为35.4%，2022年为39.8%，2023年为35.4%。2020年因新冠疫情产生的职业压力率为32.0%，2021年为26.9%，2022年为29.2%，2023年为21.4%。这两项指标在2023年官方公共卫生紧急状态结束后均有所下降。与其他服务领域相比，初级保健医生报告的职业倦怠水平最高，从2018年的46.2%到2022年的57.6%不等。2018年至2023年期间，几个服务领域的职业倦怠相对增加了10%或更多，其中心理健康、牙科和康复服务员工在此期间报告的职业倦怠率增幅最大。大部分时间进行远程工作的受访者的职业倦怠水平低于不进行远程工作的受访者。
在这项对退伍军人健康管理局医护人员的调查研究中，疫情后职业倦怠和职业压力平均有所下降，但与疫情前水平相比，职业倦怠水平仍然较高。退伍军人健康管理局已做出多项努力来减少职业倦怠和压力，结果显示出一些希望，但仍需要探索将职业倦怠降低到疫情前水平的方法。
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