Eric A Apaydin1,2,3, David C Mohr4,5, Alison B Hamilton6,7, Danielle E Rose6, Sally Haskell8, Elizabeth M Yano6,9,10. 1. Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. eric.apaydin@va.gov. 2. RAND Corporation, Santa Monica, CA, USA. eric.apaydin@va.gov. 3. VA Greater Los Angeles Healthcare System, MC 152, Bldg 206 Rm 252, 11301 Wilshire Blvd, Los Angeles, CA, 90073, USA. eric.apaydin@va.gov. 4. Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, MA, USA. 5. Department of Health Law, Policy & Management, School of Public Health, Boston University, Boston, MA, USA. 6. Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. 7. Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA. 8. Pain Research, Informatics, Multi-morbidities, and Education Center, VA Connecticut Healthcare System, West Haven, CT, USA. 9. Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA. 10. Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Abstract
BACKGROUND: Although they are a minority of patients served by the Veterans Health Administration (VHA), women Veterans comprise a fast-growing segment of these patients and have unique clinical needs. Women's health primary care providers (WH-PCPs) are specially trained and designated to provide care for women Veterans. Prior work has demonstrated that WH-PCPs deliver better preventative care and have more satisfied patients than PCPs without the WH designation. However, due to unique clinical demands or other factors, WH-PCPs may experience more burnout and intent to leave practice than general PCPs in the VHA. OBJECTIVE: To examine differences in burnout and intent to leave practice among WH and general PCPs in the VHA. DESIGN: Multi-level logistic regression analysis of three cross-sectional waves of PCPs within the VHA using the national All Employee Survey and practice data (2017-2019). We modeled outcomes of burnout and intent to leave practice as a function of WH provider designation, gender, and other demographics and practice characteristics, such as support staff ratio, panel size, and setting. PARTICIPANTS: A total of 7903 primary care providers (5152 general PCPs and 2751 WH-PCPs; response rates: 63.9%, 65.7%, and 67.5% in 2017, 2018, and 2019, respectively). MAIN MEASURES: Burnout and intent to leave practice. KEY RESULTS: WH-PCPs were more burned out than general PCPs (unadjusted: 55.0% vs. 46.9%, p<0.001; adjusted: OR=1.29, 95% confidence interval [CI] 1.10-1.55) but did not have a higher intention to leave (unadjusted: 33.4% vs. 32.1%, p=0.27; adjusted: OR=1.07, CI 0.81-1.41). WH-PCPs with intentions to leave were more likely to select the response option of "job-related (e.g., type of work, workload, burnout, boredom)" as their primary reason to leave. CONCLUSIONS: Burnout is higher among WH-PCPs compared to general PCPs, even after accounting for provider and practice characteristics. More research on causes of and solutions for these differences in burnout is needed.
BACKGROUND: Although they are a minority of patients served by the Veterans Health Administration (VHA), women Veterans comprise a fast-growing segment of these patients and have unique clinical needs. Women's health primary care providers (WH-PCPs) are specially trained and designated to provide care for women Veterans. Prior work has demonstrated that WH-PCPs deliver better preventative care and have more satisfied patients than PCPs without the WH designation. However, due to unique clinical demands or other factors, WH-PCPs may experience more burnout and intent to leave practice than general PCPs in the VHA. OBJECTIVE: To examine differences in burnout and intent to leave practice among WH and general PCPs in the VHA. DESIGN: Multi-level logistic regression analysis of three cross-sectional waves of PCPs within the VHA using the national All Employee Survey and practice data (2017-2019). We modeled outcomes of burnout and intent to leave practice as a function of WH provider designation, gender, and other demographics and practice characteristics, such as support staff ratio, panel size, and setting. PARTICIPANTS: A total of 7903 primary care providers (5152 general PCPs and 2751 WH-PCPs; response rates: 63.9%, 65.7%, and 67.5% in 2017, 2018, and 2019, respectively). MAIN MEASURES: Burnout and intent to leave practice. KEY RESULTS: WH-PCPs were more burned out than general PCPs (unadjusted: 55.0% vs. 46.9%, p<0.001; adjusted: OR=1.29, 95% confidence interval [CI] 1.10-1.55) but did not have a higher intention to leave (unadjusted: 33.4% vs. 32.1%, p=0.27; adjusted: OR=1.07, CI 0.81-1.41). WH-PCPs with intentions to leave were more likely to select the response option of "job-related (e.g., type of work, workload, burnout, boredom)" as their primary reason to leave. CONCLUSIONS: Burnout is higher among WH-PCPs compared to general PCPs, even after accounting for provider and practice characteristics. More research on causes of and solutions for these differences in burnout is needed.
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