背景:招聘农村执业临床医生是一个高度优先事项。在这项研究中,我们探索了农村职业倦怠和贡献工作条件,城市,以及中西部上层医疗保健系统中的家庭执业医生和高级执业临床医生(APC)。
方法:2022年3月通过匿名电子调查实施了MiniZ倦怠降低措施。我们对研究变量进行了双变量分析,然后用多元二元逻辑回归评估研究变量与职业倦怠的关系。
结果:1118名临床医生(63%的反应率),该研究包括589名医生和496名APC(n=1085)。大多数是女性(56%)。医生(54%),白人(86%)21%的人在家庭诊所,46%的人报告倦怠,349人在农村练习。农村和城市临床医生的倦怠率相当(45%比47%)。兼职工作可以防止家庭执业和农村临床医生职业倦怠,但不是城市临床医生。在农村临床医生的多变量模型中,应力(OR:8.53,95%CI:4.09至17.78,P<.001),缺乏工作量控制(OR:3.06,95%CI:1.47-6.36,P=.003),繁忙/混乱的环境(OR:2.53,95%CI:1.29-4.99,P=.007),和打算离开(OR:2.18,95%CI:1.06-4.45,P=0.033)增加了职业倦怠的几率。在家庭实践临床医生中,压力(OR:13.4395%CI:4.90-36.79,P<.001)也显着增加了职业倦怠的几率。
结论:城乡医生和APCs的倦怠相当。兼职工作与农村和家庭执业临床医生的倦怠减少有关。解决倦怠司机(压力,工作负载控制,混乱)可能会改善农村工作环境,减少营业额,并帮助农村临床医生招募。解决压力在家庭实践中可能特别有影响力。
BACKGROUND: Recruiting rural-practicing clinicians is a high priority. In this study, we explored burnout and contributing work conditions among rural, urban, and family practice physicians and advanced practice clinicians (APCs) in an Upper Midwestern health care system.
METHODS: The Mini Z burnout reduction measure was administered by anonymous electronic survey in March 2022. We conducted bivariate analyses of study variables, then assessed relationships of study variables to burnout with multivariate binary logistic regression.
RESULTS: Of 1118 clinicians (63% response rate), 589 physicians and 496 APCs were included in this study (n = 1085). Most were female (56%), physicians (54%), and White (86%), while 21% were in family practice, 46% reported burnout, and 349 practiced rurally. Rural and urban clinician burnout rates were comparable (45% vs 47%). Part-time work protected against burnout for family practice and rural clinicians, but not urban clinicians. In multivariate models for rural clinicians, stress (OR: 8.53, 95% CI: 4.09 to 17.78, P < .001), lack of workload control (OR: 3.06, 95% CI: 1.47-6.36, P = .003), busy/chaotic environments (OR: 2.53, 95% CI: 1.29-4.99, P = .007), and intent to leave (OR: 2.18, 95% CI: 1.06-4.45, P = .033) increased burnout odds. In family practice clinicians, stress (OR: 13.43 95% CI: 4.90-36.79, P < .001) also significantly increased burnout odds.
CONCLUSIONS: Burnout was comparable between rural and urban physicians and APCs. Part-time work was associated with decreased burnout in rural and family practice clinicians. Addressing burnout drivers (stress, workload control, chaos) may improve rural work environments, reduce turnover, and aid rural clinician recruitment. Addressing stress may be particularly impactful in family practice.