背景:日本加班时间过长的文化最近尚未得到解决。关于工作时间的新立法,包括限制医生的最大加班时间,将于2024年实施。进行这项研究是为了阐明专职医院医生的工作条件并讨论各种政策含义。
方法:2022年7月进行了关于医生工作条件的设施调查和医生调查。设施调查被发送到日本的所有医院,医生调查被发送给一半医院的所有医生。要求医生报告2022年7月11日至17日的工作时间。除了描述性统计,对导致工作时间长的因素进行多因素logistic回归分析.
结果:总计,11,466名全职医院医生被纳入分析。全职医院医生每周工作50.1小时。他们在主要医院花费了45.6小时(90.9%),进行了4.6小时(9.1%)的工作。他们在临床工作上花费了43.8小时(87.5%),在临床工作以外的活动上花费了6.3小时(12.5%),比如研究,教学,和其他活动。神经外科医生工作时间最长,其次是外科医生和急诊医生。总的来说,估计20.4%的医生超过960小时的年度加班限制,估计有3.9%超过1860小时的限制。仅在其基层医院中,总共有13.3%和2.0%超过了这一水平,在不包括执行辅助工作的时间后。Logistic回归分析显示,男性,年龄较小,在大学医院工作,在临床实践领域工作,工作时间长,在控制其他因素后,接受专业培训与长时间工作有关。
结论:随着对医生的加班规定的临近应用,观察到工作时间有所减少。然而,许多医生的工作时间仍然超过指定的加班上限。必须进一步推进工作改革,精简工作,转移任务,在保障高校医院科研等职能的同时,教育,并支持社区的医疗保健。
The culture of excessively long overtime work in Japan has not been recently addressed. New legislation on working hours, including a limitation on maximum overtime work for physicians, will be enforced in 2024. This study was performed to elucidate the working conditions of full-time hospital physicians and discuss various policy implications.
A facility survey and a physician survey regarding physicians\' working conditions were conducted in July 2022. The facility survey was sent to all hospitals in Japan, and the physician survey was sent to all physicians working at half of the hospitals. The physicians were asked to report their working hours from 11 to 17 July 2022. In addition to descriptive statistics, a multivariate logistic regression analysis on the factors that lead to long working hours was conducted.
In total, 11,466 full-time hospital physicians were included in the analysis. Full-time hospital physicians worked 50.1 h per week. They spent 45.6 h (90.9%) at the main hospital and 4.6 h (9.1%) performing side work. They spent 43.8 h (87.5%) on clinical work and 6.3 h (12.5%) on activities outside clinical work, such as research, teaching, and other activities. Neurosurgeons worked the longest hours, followed by surgeons and emergency medicine physicians. In total, 20.4% of physicians were estimated to exceed the annual overtime limit of 960 h, and 3.9% were estimated to exceed the limit of 1860 h. A total of 13.3% and 2.0% exceeded this level only at their primary hospital, after excluding hours performing side work. Logistic regression analysis showed that male, younger age, working at a university hospital, working in clinical areas of practice with long working hours, and undergoing specialty training were associated with long working hours after controlling for other factors.
With the approaching application of overtime regulations to physicians, a certain reduction in working hours has been observed. However, many physicians still work longer hours than the designated upper limit of overtime. Work reform must be further promoted by streamlining work and task-shifting while securing the functions of university hospitals such as research, education, and supporting healthcare in communities.