Effects of organisational and patient factors on doctors' burnout: a national survey in China

Yao Cheng; Fang Wang; Liuyi Zhang; Ping Zhang; Beizhu Ye; Yi Sun; Xi Zhu; Naixing Zhang; Yuan Liang

doi:10.1136/bmjopen-2018-024531

Effects of organisational and patient factors on doctors' burnout: a national survey in China

BMJ Open. 2019 Jul 1;9(7):e024531. doi: 10.1136/bmjopen-2018-024531.

Authors

Yao Cheng¹, Fang Wang², Liuyi Zhang², Ping Zhang², Beizhu Ye², Yi Sun², Xi Zhu³, Naixing Zhang⁴, Yuan Liang²

Affiliations

¹ Department of Epidemiology and Biostatistics, Public Health School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Department of Social Medicine and Health Management, Public Health School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³ Health Management and Policy, College of Public Health, The University of Lowa, Lowa City, Lowa, USA.
⁴ Department of Medical Administration, Health and Family Planning Commission of Shenzhen, Shenzhen, China.

Abstract

Objectives: To measure the burnout of doctors affiliated with western medicine (WM) and traditional Chinese medicine (TCM) hospitals and to evaluate its relationships with organisational and patient factors.

Design: A national cross-sectional study in China.

Setting: By convenience sampling, this study was conducted in 64 general hospitals from six provinces and Beijing between July 2014 and April 2015. There were a total of 2576 eligible participants, including 1766 WM doctors and 810 TCM doctors in this study.

Primary outcome measures: Burnout symptoms of emotional exhaustion, job involvement and personal accomplishment were measured.

Results: In total, 73.6% of doctors reported emotional exhaustion, the core component of burnout. In multivariable models, emotional exhaustion was significantly associated with organisational factors, including salary fairness [WM: odds ratio (OR)=2.36, 95% confidence interval (CI): 1.80 to 3.09; TCM: OR=1.59, 95% CI: 1.08 to 2.33], participation in organisational decision-making (WM: OR=1.58, 95% CI: 1.21 to 2.08; TCM: OR=1.84, 95% CI: 1.23 to 2.74), professional value (WM: OR=1.74, 95% CI: 1.35 to 2.25), frequency of participation in full-time training (TCM: OR=1.48, 95% CI: 1.01 to 2.16) and frequency of participation in clinical meetings (WM: OR=1.53, 95% CI: 1.11 to 2.10; TCM: OR=2.48, 95% CI: 1.57 to 3.92). Patient factors are also associated with burnout among both WM and TCM doctors, including respect (WM: OR=1.73, 95% CI: 1.31 to 2.28; TCM: OR=1.65, 95% CI: 1.10 to 2.45) and unreasonable demands (WM: OR=2.31, 95% CI: 1.68 to 3.20; TCM: OR=3.44, 95% CI: 2.15 to 5.49). Moreover, job involvement and personal accomplishment among both WM and TCM doctors were significantly associated with organisational and patient factors.

Conclusions: Our results suggest that improving organisational management and patient behaviours may be beneficial to reduce doctors' burnout. Our findings require further validation in different organisational settings.

Keywords: China; health professionals; job burnout; organizational factors; patient factors.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Burnout, Professional / psychology*
China
Cross-Sectional Studies
Female
Hospitals
Humans
Logistic Models
Male
Medicine, Chinese Traditional*
Middle Aged
Organizational Culture*
Physician-Patient Relations*
Physicians / psychology*
Surveys and Questionnaires
Young Adult