COVID ‐19 and Physician Burnout in the United States: Cross‐Sectional and Longitudinal Evidence From a National Survey
本研究利用2019和2022年美国全国医生调查数据，发现COVID-19导致医生职业倦怠显著增加，工作时间和转科是重要因素，为政策制定者提供缓解未来公共卫生危机影响的依据。
OBJECTIVE: To evaluate the impact of the COVID-19 pandemic on physician burnout. STUDY SETTING AND DESIGN: This observational study spanned from 2019 to 2022, involving active US physicians from various settings. We applied logistic regression to cross-sectional data to examine the associations between COVID-19-affected aspects of physicians' work and practice and physician burnout, and used repeated measures of ANOVA on longitudinal data to determine changes in burnout before and during COVID-19. DATA SOURCES AND ANALYTIC SAMPLE: Both cross-sectional (n = 5917) and longitudinal data (n = 2429) were drawn from the Association of American Medical Colleges (AAMC)'s National Sample Survey of Physicians (NSSP), collected in 2019 and 2022. Burnout was measured using a Maslach Burnout Inventory item, while COVID-19-affected aspects were reported in 2022. PRINCIPAL FINDINGS: In 2022, 31.68% of respondents reported burnout once a week or higher. One in five physicians (19.43%) reported that COVID affected at least one aspect of their work status, while 67.77% reported that it affected at least one aspect of their practice. Cross-sectional analysis found that high burnout was reported by 30.41% of physicians whose work was not affected by COVID-19, compared to 37.00% (95% CI: 32.20-41.79, p = 0.015) among those who reported at least one affected aspect. Similarly, high burnout was reported by 27.19% of physicians with no COVID-affected practice aspects and 33.83% (95% CI: 31.42-36.24, p = 0.002) of those with at least one affected aspect. Longitudinal analysis revealed a 0.07 (p = 0.001) increase in burnout frequency on the 0-4 scale from 2019 to 2022. Increased work hours (b = 0.01, p < 0.001) and transitioning from other specialties into primary care specialties (b = 0.15, p < 0.001) significantly contributed to increased burnout. CONCLUSIONS: These findings quantify the detrimental effects of COVID-19-related work and practice changes on burnout and provide insights for policymakers and healthcare organizations to develop targeted strategies to mitigate the negative impacts of future public health crises.