The Impact of Administrative Burden on Academic Physicians: Results of a Hospital-Wide Physician Survey
The Impact of Administrative Burden on Academic Physicians: Results of a Hospital-Wide Physician Survey
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DOI：
10.1097/acm.0000000000001461
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发表时间：
2017-02-01
影响因子：
7.4
通讯作者：
Torchiana, David F.
中科院分区：
文献类型：
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作者：
Rao, Sandhya K.;Kimball, Alexa B.;Torchiana, David F.
目的确定受行政负担影响最大的临床活跃学术医师的特征；学术型医生的行政负担、倦怠和职业满意度之间的相关性；以及特定管理任务的相对价值和负担。方法作者分析了 2014 年马萨诸塞州普通医师组织调查的数据。受访者报告了他们花在与患者相关的管理职责上的时间百分比，并评估了与特定管理任务相关的价值和负担。五点李克特量表和多元回归确定了行政负担的预测因素，并评估了行政负担对护理质量感知、职业满意度和倦怠的影响。结果在符合条件的劳动力中，1,774 名医生 (96%) 回复了调查。平均 24% 的工作时间花在行政事务上。据报告，与其他医生相比，初级保健医生和女性在行政职责上花费了更多的时间。三分之二的受访者表示，行政职责会对他们提供高质量护理的能力产生负面影响。那些花在行政职责上的时间比例较高的医生，其职业满意度较低，倦怠程度较高，并且更有可能考虑在未来减少看诊病人的数量。事先授权、临床文件和药物协调被评为最繁重的任务。结论行政职责需要医生大量时间，并影响医生对能够提供高质量护理、职业满意度、倦怠和继续临床实践的可能性的看法。不同专业的行政负担存在差异，多个工作领域构成了整体行政工作量。
PurposeTo determine the characteristics of clinically active academic physicians most affected by administrative burden; the correlation between administrative burden, burnout, and career satisfaction among academic physicians; and the relative value and burden of specific administrative tasks.MethodThe authors analyzed data from the 2014 Massachusetts General Physicians Organization Survey. Respondents reported the percentage of time they spent on patient-related administrative duties and rated the value and burden associated with specific administrative tasks. A five-point Likert scale and multivariate regression identified predictors of administrative burden and assessed the impact of administrative burden on perceived quality of care, career satisfaction, and burnout.ResultsOf the eligible workforce, 1,774 physicians (96%) responded to the survey. On average, 24% of working hours were spent on administrative duties. Primary care physicians and women reported spending more time on administrative duties compared with other physicians. Two-thirds of respondents reported that administrative duties negatively affect their ability to deliver high-quality care. Physicians who reported higher percentages of time spent on administrative duties had lower levels of career satisfaction, higher levels of burnout, and were more likely to be considering seeing fewer patients in the future. Prior authorizations, clinical documentation, and medication reconciliation were rated the most burdensome tasks.ConclusionsAdministrative duties required substantial physician time and affected physicians' perceptions of being able to deliver high-quality care, career satisfaction, burnout, and likelihood to continue clinical practice. There is variation in administrative burden across specialties, and multiple areas of work contribute to overall administrative workload.