Abstract
BackgroundHealth workers are at high risk of job burnout. Primary care in China has recently expanded its scope of services to a broader range of public health services in addition to clinical care. This study aims to measure the prevalence of burnout and identify its associated factors among clinical care and public health service providers at primary care facilities.MethodsA cross-sectional survey (2018) was conducted among 17,816 clinical care and public health service providers at 701 primary care facilities from six provinces. Burnout was measured by the Chinese version of the Maslach Burnout Inventory-General Scale, and multilevel linear regression analysis was conducted to identify burnout’s association with demographics, as well as occupational and organisational factors.ResultsOverall, half of the providers (50.09%) suffered from burnout. Both the presence of burnout and the proportion of severe burnout among public health service providers (58.06% and 5.25%) were higher than among clinical care providers (47.55% and 2.26%, respectively). Similar factors were associated with burnout between clinical care and public health service providers. Younger, male, lower-educated providers and providers with intermediate professional title, permanent contract or higher working hours were related to a higher level of burnout. Organisational environment, such as the presence of a performance-based salary system, affected job burnout.ConclusionsJob burnout is prevalent among different types of primary care providers in China, indicating the need for actions that encompass the entirety of primary care. We recommend strengthening the synergy between clinical care and public health services and transforming the performance-based salary system into a more quality-based system that includes teamwork incentives.
Highlights
Health workers are at high risk of job burnout
Study participants and facilities In total, 17,816 clinical care (CC) and public health (PH) service providers from 701 primary care (PC) facilities were included in this study
Compared with the CC group, more women (75% vs 69%), more providers who graduated from junior college or below (61% vs 58%), fewer providers with junior or senior title (26% vs 31%), fewer providers with administrative responsibilities (30% vs 33%), less average working years (9.01 vs 9.15) and fewer providers working more than 50 h per week (30% vs 45%) were in the PH service group
Summary
Health workers are at high risk of job burnout. Primary care in China has recently expanded its scope of services to a broader range of public health services in addition to clinical care. This study aims to measure the prevalence of burnout and identify its associated factors among clinical care and public health service providers at primary care facilities. Strengthening primary care (PC) to improve health system outcomes is high on the health policy agenda of most countries, and this is expected to be further reinforced in the aftermath of the current COVID-19 pandemic [1,2,3]. The differences in roles and services delivery by clinical care and public health providers are presented in Additional file 1
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