Abstract

A main objective of the Nordic healthcare systems is to deliver timely and equal access to high-quality healthcare to the entire population. Health care providers, such as general practitioners (GPs), may therefore experience pressure to deliver care from both the health authorities and patients. However, if GPs’ gains do not outweigh their costs of providing the demanded care, it may lead to job dissatisfaction and thereby potentially to poorer quality of care. This study contributes to the literature by estimating the association between different sources of experienced work pressure and job dissatisfaction among GPs. We use data from a nation-wide survey of Danish GPs distributed in 2019. The study includes six items covering GPs’ experienced work pressure, which we categorise based on the degree to which they are related to demands from either patients or health authorities. Using a series of ordered logit models with a rich set of explanatory variables, we estimate the association between the pressure measures and GP job dissatisfaction. We find that GPs reporting high or considerable work pressure have an increased likelihood of also reporting job dissatisfaction. However, we find considerable heterogeneity in this relationship across different sources of work pressure as well as across GP, practice, and area characteristics. For example, the relationship between pressure from patients’ demands for consultations and job dissatisfaction is stronger among GPs practicing in areas with an undersupply of GPs. Solo practitioners, who cannot share their administrative burdens with colleagues, experience a stronger association between pressure from the health authorities and job dissatisfaction. Policymakers should consider this heterogeneity when implementing new schemes and organisational structures affecting GPs’ work pressure. Published: Online January 2022.

Highlights

  • The objective of the Nordic healthcare systems is to deliver timely and equal access to highquality health care for the entire population

  • We find that general practitioners (GPs)’ experienced work pressure is statistically significantly positively associated with their job dissatisfaction

  • Our finding is aligned with previous studies investigating this relationship (e.g. Mello et al (2004); Van Ham et al (2006)). We contribute to this literature by showing heterogeneity in this association across different sources of work pressure and subgroups of GPs

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Summary

Introduction

The objective of the Nordic healthcare systems is to deliver timely and equal access to highquality health care for the entire population. A key task for policymakers is to ensure that GPs deliver care in alignment with these objectives This task requires an in-depth understanding of GPs’ behaviour. To predict GPs’ behaviour, we need to identify factors related to their job dissatisfaction One of these factors may be the demands GPs face from their patients and the third-party payer (Blomqvist, 1991), which is typically the health authorities in a Nordic setting. These demands may be experienced as pressure related to the provision of different tasks, e.g. provision of consultations, services within consultations, implementation of clinical guidelines, paperwork etc. Our study aims to estimate how GPs’ experienced pressure from demands are associated with GPs’ job dissatisfaction

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