Abstract
Excessive overtime work, which is a serious problem among Chinese physicians, is the primary reason for night clinic closure policies. The aim of this study was to evaluate the effects of such policies on physicians’ workload and satisfaction. Physicians at the hospital, which closed its night clinic in 2017, were selected as the intervention group, and those at another hospital, which still operates a night clinic, were chosen as the control group. In total, 829 participating physicians self-reported their characteristics and responded to questions on three effect indicators: weekly hours worked, work–family balance, and job satisfaction; the index years were for 2016 and 2017. A pre–post-with-control-group study design and the difference-in-difference (DID) methodology were employed to evaluate the effect of night clinic closure. After adjusting for physicians’ characteristics, the effect of all variables, except hours worked per week, on work–family balance and job satisfaction remained significant. Although the adjusted effect on hours worked per week was not significant, our results suggest that minor policy changes that reduce the workload of physicians may nonetheless benefit this group. However, as the satisfaction scores remained low, other policies should be implemented to relieve the workload and improve satisfaction among physicians.
Highlights
The primary aim of night clinics is to ensure the confidentiality of patients, especially those with mental health problems or HIV infection [1,2,3]
38.0% of physicians in the intervention group reported that their salary was less than 5000 CNY, which was higher than the proportion in the control group (8.0%, P
Its effect on hours worked per week was insignificant, the policy of night clinic closure can clearly help physicians to maintain a balance between work and family life, and improve their job satisfaction; the policy had an overall positive effect on the intervention group
Summary
The primary aim of night clinics is to ensure the confidentiality of patients, especially those with mental health problems or HIV infection [1,2,3]. As a result of the universal coverage of health insurance in China, the number of patients visiting hospitals has increased sharply [6,7,8]. The average number of hours worked per week was 50.9 for male physicians and 49.8 for female physicians [13]. Long work hours are the most important contributor to physician dissatisfaction, which is negatively associated with patient satisfaction and healthcare quality [15]. In 2017, a tertiary teaching hospital located in Beijing closed its night clinic to reduce the physicians’ workload
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