Estimating the Attributable Cost of Physician Burnout in the United States

被引:529
作者
Han, Shasha [1 ,9 ]
Shanafelt, Tait D. [2 ,10 ]
Sinsky, Christine A. [3 ]
Awad, Karim M. [4 ,11 ]
Dyrbye, Liselotte N. [5 ]
Fiscus, Lynne C. [6 ,12 ]
Trockel, Mickey [2 ,13 ]
Goh, Joel [1 ,7 ,8 ]
机构
[1] Natl Univ Singapore, Singapore, Singapore
[2] Stanford Univ, Sch Med, Palo Alto, CA 94304 USA
[3] Amer Med Assoc, 330 North Wabash Ave, Chicago, IL 60611 USA
[4] Atrius Hlth, Boston, MA USA
[5] Mayo Clin, 200 First St Southwest, Rochester, MN 55905 USA
[6] Univ North Carolina Phys Network, Morrisville, NC USA
[7] Harvard Sch Business, Boston, MA USA
[8] Natl Univ Singapore, Business Sch, 15 Kent Ridge Dr,08-04, Singapore 119245, Singapore
[9] Natl Univ Singapore, Business Sch, 15 Kent Ridge Dr,08-69, Singapore 119245, Singapore
[10] 300 Pasteur Dr,Suite 3215, Stanford, CA 94305 USA
[11] 133 Brookline Ave, Boston, MA 02215 USA
[12] 613 Sugarberry Rd, Chapel Hill, NC 27514 USA
[13] Psychiat Clin, 401 Quarry Rd,Room 2303, Stanford, CA 94305 USA
基金
美国国家卫生研究院;
关键词
WORK-LIFE BALANCE; CAREER SATISFACTION; MEDICAL ERRORS; PATIENT-CARE; ASSOCIATION; POPULATION; OUTCOMES; PLANS;
D O I
10.7326/M18-1422
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Although physician burnout is associated with negative clinical and organizational outcomes, its economic costs are poorly understood. As a result, leaders in health care cannot properly assess the financial benefits of initiatives to remediate physician burnout. Objective: To estimate burnout-associated costs related to physician turnover and physicians reducing their clinical hours at national (U.S.) and organizational levels. Design: Cost-consequence analysis using a mathematical model. Setting: United States. Participants: Simulated population of U.S. physicians. Measurements: Model inputs were estimated by using the results of contemporary published research findings and industry reports. Results: On a national scale, the conservative base-case model estimates that approximately $4.6 billion in costs related to physician turnover and reduced clinical hours is attributable to burnout each year in the United States. This estimate ranged from $2.6 billion to $6.3 billion in multivariate probabilistic sensitivity analyses. At an organizational level, the annual economic cost associated with burnout related to turnover and reduced clinical hours is approximately $7600 per employed physician each year. Limitations: Possibility of nonresponse bias and incomplete control of confounders in source data. Some parameters were unavailable from data and had to be extrapolated. Conclusion: Together with previous evidence that burnout can effectively be reduced with moderate levels of investment, these findings suggest substantial economic value for policy and organizational expenditures for burnout reduction programs for physicians.
引用
收藏
页码:784 / +
页数:8
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