A Preliminary Study on the Abnormal Deaths and Work Burden of Chinese Physicians: A Mixed Method Analysis and Implications for Smart Hospital Management.
A Preliminary Study on the Abnormal Deaths and Work Burden of Chinese Physicians: A Mixed Method Analysis and Implications for Smart Hospital Management.
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中国医生非正常死亡与工作负担的初步研究：混合方法分析及对智慧医院管理的启示
DOI：
10.3389/fpubh.2021.803089
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发表时间：
2021
影响因子：
5.2
通讯作者：
Lei J
中科院分区：
文献类型：
--
作者：
Liang J;He Y;Fan L;Nuo M;Shen D;Xu J;Zheng X;Wang T;Qian H;Lei J
背景：中国医师群体经常受到非正常死亡的威胁，包括过劳死或他杀。这不仅是一个健康问题，也是一个社会问题，已经引起了医院和政府的注意。目的：分析2007 - 2020年中国医院医师非正常死亡的特点，探讨非正常死亡与医师工作量的关系，为决策者提供信息，提出改进技术建议。方法：采用混合研究方法。为了保证准确性和完整性，我们利用多个异构数据源对2007 - 2020年中国医院医师非正常死亡进行了较为全面的检索。然后，采用与工作相关的过劳死风险概念框架和演绎扎根理论方法对收集的案例进行描述性分析。此外，根据三个重要工作量指标计算2007 - 2019年医生的工作量。结果：2007年至2020年，中国大陆公开报道了207例医师非正常死亡事件。在207名受害者中，大部分（79%）死于过度劳累或猝死。男性受害者人数是女性的5.5倍，受害者年龄在31-50岁之间。这些医生主要来自外科、麻醉科、内科和骨科。对过度劳累死亡病例中直接死亡原因的进一步分析表明，51名医生（31.1%）死于心源性疾病。此外，从2007年到2019年，中国医生的人均工作量急剧增加了约42%，远远超过了欧洲、亚洲和澳大利亚的医生工作量（2017年每名医生的住院人数：72对55、50、45）。分析发现，中国医师异常死亡人数与医师人均住院人数之间存在较强的相关性（r = 0.683, P = 0.01）。结论：高强度工作环境可能与医师异常死亡人数呈正相关。智能医院技术有可能缓解这种情况。
Background: The population of Chinese physicians is frequently threatened by abnormal death, including death by overwork or homicide. This is not only a health problem, but also a social problem that has attracted the attention of both hospitals and the government. Objective: This study aims to analyze the characteristics of abnormal death in physicians in Chinese hospitals from 2007 to 2020 and to investigate the relationship between abnormal death and physician workload, in order to provide information for policy makers and request improvement technologies. Methods: A mixed research method was used. In order to ensure accuracy and completeness, a relatively comprehensive search was conducted using multiple heterogeneous data sources on the abnormal death of physicians in Chinese hospitals from 2007 to 2020. The collected cases were then descriptively analyzed using the work-related overwork death risk concept framework and the deductive grounded theory approach. In addition, the workload of physicians was calculated between 2007 and 2019 based on three important workload indicators. Results: Between 2007 and 2020, 207 abnormal death events of physicians on the Chinese mainland were publicly reported. Among the 207 victims, the majority (~79%) died from overwork or sudden death. The number of victims who were men was 5.5 times higher than that of women, and victims were between the ages of 31–50 years. These physicians mainly belonged to the departments of surgery, anesthesiology, internal medicine, and orthopedics. Further analysis of the direct causes of death in cases of overwork death showed that 51 physicians (31.1%) died from cardiogenic diseases. Additionally, the per capita workload of physicians in China increased drastically by about 42% from 2007 to 2019, far exceeding physician workloads in Europe, Asia, and Australia (number of inpatients per physician in 2017: 72 vs. 55, 50, 45). The analysis revealed that there was a strong correlation between the number of abnormal deaths of physicians in China and the number of inpatients per physician (r = 0.683, P = 0.01). Conclusion: High-intensity working conditions may be positively correlated with the number of abnormal deaths among physicians. Smart hospital technologies have the potential to alleviate this situation.
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