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医院在职妇产科医生的长时间工作及其相关因素:一项基于全国性调查的比较研究。

Long working hours among hospital-employed obstetricians and gynecologists and associated factors: a comparative study based on a nationwide survey.

作者信息

Ishikawa Masatoshi, Seto Ryoma, Oguro Michiko, Sato Yoshino

机构信息

Research Institute, Tokyo Healthcare University, Tokyo, Japan.

出版信息

Environ Occup Health Pract. 2025 Jun 10;7(1). doi: 10.1539/eohp.2024-0018. eCollection 2025.

Abstract

OBJECTIVES

To elucidate the status of reduction in working hours following physician work-style reforms and factors associated with long working hours.

METHODS

A nationwide questionnaire survey was conducted among obstetricians and gynecologists (OB/GYNs) working in hospitals. The survey elucidated actual working conditions, including working hours and number of out-of-hour (OOH) shifts. To identify factors associated with long working hours, a multivariate logistic regression analysis was performed, with ≥60 or ≥80 working hours per week as dependent variables and OB/GYNs attributes (sex, age, job position, hospital type by ownership, total number of hospital beds, and regional characteristics) as independent variables.

RESULTS

Questionnaires were sent to 1,170 hospitals. Valid responses were obtained from 1164 OB/GYNs at 423 hospitals (response rate: 36%): 26.0% worked ≥60 hours per week, a reduction from 58.1% in 2019 (equivalent to over 960 hours of overtime annually), 5.4% worked ≥80 hours per week, a reduction from 41.2% in 2019 (equivalent to over 1,920 hours of overtime annually); and 46.9% worked OOH shifts ≥5 times per month. Factors significantly associated with long working hours per week included male sex, resident position, teaching duty, and number of OOH shifts.

CONCLUSIONS

Although the working hours of OB/GYNs have decreased because of physician work-style reforms initiated in 2019, long working hours persist. To ensure health of OB/GYNs and patient safety, it is necessary to actively promote physician work-style reforms and advance measures aimed at the centralization of medical resources and addressing their maldistribution.

摘要

目的

阐明医师工作方式改革后工作时长的减少情况以及与长时间工作相关的因素。

方法

对在医院工作的妇产科医生进行了一项全国性问卷调查。该调查阐明了实际工作条件,包括工作时长和非工作时间(OOH)值班次数。为确定与长时间工作相关的因素,进行了多变量逻辑回归分析,以每周工作时长≥60小时或≥80小时作为因变量,妇产科医生的属性(性别、年龄、职位、医院所有制类型、医院病床总数和地区特征)作为自变量。

结果

向1170家医院发送了问卷。从423家医院的1164名妇产科医生处获得了有效回复(回复率:36%):26.0%的人每周工作≥60小时,较2019年的58.1%有所下降(相当于每年加班超过960小时),5.4%的人每周工作≥80小时,较2019年的41.2%有所下降(相当于每年加班超过1920小时);46.9%的人每月值OOH班≥5次。与每周长时间工作显著相关的因素包括男性、住院医师职位、教学职责和OOH值班次数。

结论

尽管由于2019年启动的医师工作方式改革,妇产科医生的工作时长有所减少,但长时间工作的情况仍然存在。为确保妇产科医生的健康和患者安全,有必要积极推动医师工作方式改革,并推进旨在集中医疗资源和解决其分布不均问题的措施。

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