Physician Burnout and Higher Clinic Capacity to Address Patients' Social Needs
Physician Burnout and Higher Clinic Capacity to Address Patients' Social Needs
复制标题
DOI：
10.3122/jabfm.2019.01.180104
复制
发表时间：
2019-01-01
影响因子：
2.9
通讯作者：
Gottlieb, Laura M.
中科院分区：
文献类型：
--
作者：
De Marchis, Emilia;Knox, Margae;Gottlieb, Laura M.
背景资料：最近的一项区域研究发现，初级保健临床医生认为他们的诊所有更大的能力来满足病人的社会需求，他们的倦怠程度较低。我们的目的是更全面地调查诊所能力，以解决社会需求和倦怠之间的关联，通过使用国家数据，其中包括一个更有代表性的样本的家庭医生和一个更全面的实践水平的变量，是潜在的混淆因素之间的关联诊所的社会需求能力和倦怠。方法：我们对2016年申请继续获得美国家庭医学委员会认证的1298名家庭医生进行了横断面分析。Logistic回归分析被用来测试医师和临床特征，感知临床社会需求能力，和burners.Results之间的关联：共有27%的家庭医生报告倦怠。对自己诊所满足患者社会需求的能力有较高认识的医生不太可能报告倦怠（调整后的比值比[OR] 0.66; 95%置信区间[CI]，0.47 - 0.91）。那些报告诊所有能力解决病人社会需求的医生更有可能报告有社会工作者（校正OR，2.16; 95% CI，1.44 - 3.26）或药剂师（调整后OR，1.73; 95% CI，1.18 - 2.53）在他们的护理团队和以患者为中心的医疗之家工作结论：通过解决结构性问题，如提高应对患者社会需求的能力，以及针对其他可改变的职业倦怠风险，可以进一步减少初级保健医生的职业倦怠。
Background: A recent regional study found lower burnout among primary care clinicians who perceived that their clinic had greater capacity to meet patients' social needs. We aimed to more comprehensively investigate the association between clinic capacity to address social needs and burnout by using national data that included a more representative sample of family physicians and a more comprehensive set of practice-level variables that are potential confounders of an association between clinic social needs capacity and burnout.Methods: We conducted a cross-sectional analysis of 1298 family physicians in ambulatory primary care settings who applied to continue certification with the American Board of Family Medicine in 2016. Logistic regression was used to test associations between physician and clinic characteristics, perceived clinic social needs capacity, and burnout.Results: A total of 27% of family physicians reported burnout. Physicians with a high perception of their clinic's ability to meet patients' social needs were less likely to report burnout (adjusted odds ratio [OR] 0.66; 95% confidence interval [CI], 0.47-0.91). Physicians who reported high clinic capacity to address patients' social needs were more likely to report having a social worker (adjusted OR, 2.16; 95% CI, 1.44-3.26) or pharmacist (adjusted OR, 1.73; 95% CI, 1.18-2.53) on their care team and working in a patient-centered medical home (adjusted OR, 1.65; 95% CI, 1.24-2.21).Conclusion: Efforts to reduce primary care physician burnout may be furthered by addressing structural issues, such as improving capacity to respond to patients' social needs in addition to targeting other modifiable burnout risks.