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首页> 外文期刊>BMJ quality & safety >Mental well-being, job satisfaction and self-rated workability in general practitioners and hospitalisations for ambulatory care sensitive conditions among listed patients: a cohort study combining survey data on GPs and register data on patients
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Mental well-being, job satisfaction and self-rated workability in general practitioners and hospitalisations for ambulatory care sensitive conditions among listed patients: a cohort study combining survey data on GPs and register data on patients

机译：在上市患者中，普通从业者和住院中的精神幸福，工作满意度和自我评价的可加工性：一项队列研究GPS上的调查数据和患者注册数据的队列研究

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Physicians’ work conditions and mental well-being may affect healthcare quality and efficacy. Yet the effects on objective measures of healthcare performance remain understudied. This study examined mental well-being, job satisfaction and self-rated workability in general practitioners (GPs) in relation to hospitalisations for ambulatory care sensitive conditions (ACSC-Hs), a register-based quality indicator affected by referral threshold and prevention efforts in primary care.This is an observational study combining data from national registers and a nationwide questionnaire survey among Danish GPs. To ensure precise linkage of each patient with a specific GP, partnership practices were not included. Study cases were 461 376 adult patients listed with 392 GPs. Associations between hospitalisations in the 6-month study period and selected well-being indicators were estimated at the individual patient level and adjusted for GP gender and seniority, list size, and patient factors (comorbidity, sociodemographic characteristics).The median number of ACSC-Hs per 1000 listed patients was 10.2 (interquartile interval: 7.0–13.7). All well-being indicators were inversely associated with ACSC-Hs, except for perceived stress (not associated). The adjusted incidence rate ratio was 1.26 (95% CI 1.13 to 1.42) for patients listed with GPs in the least favourable category of self-rated workability, and 1.19 (95% CI 1.05 to 1.35), 1.15 (95% CI 1.04 to 1.27) and 1.14 (95% CI 1.03 to 1.27) for patients listed with GPs in the least favourable categories of burn-out, job satisfaction and general well-being (the most favourable categories used as reference). Hospitalisations for conditions not classified as ambulatory care sensitive were not equally associated.ACSC-H frequency increased with decreasing levels of GP mental well-being, job satisfaction and self-rated workability. These findings imply that GPs’ work conditions and mental well-being may have important implications for individual patients and for healthcare expenditures.
机译：医生的工作条件和心理健康可能会影响医疗保健质量和疗效。然而，对医疗保健性能客观措施的影响仍然被解读。本研究审查了通用从业者（GPS）的心理福祉，工作满意度和自我评价的可加工性，与住院治疗敏感条件（ACSC-HS），基于寄存器的质量指标，受转介门槛和预防努力影响的寄存器为基础的质量指标初级保健。这是一个观察研究，将来自国家登记册和全国范围内的丹麦GPS中的全国调查问卷调查结合起来。为了确保每位患者具有特定GP的确切联系，不包括伙伴关系实践。研究病例为461 376名成年患者，患有392个GPS。在6个月的研究期间和所选福祉指标中的住院期间和所选福祉指标的协会在个人患者水平上估计，并调整了GP性别和资历，名单规模和患者因素（合并症，社会造影特征）。中位数的ACSC-每1000名上市患者的HS为10.2（间隔：7.0-13.7）。除感知的压力（无相关）外，所有福祉指标与ACSC-HS相反。在最低良好的自额定可加工性类别中，GPS列出的患者，调整后发病率比为1.26（95％CI 1.13至1.42），1.19（95％CI 1.05至1.35），1.15（95％CI 1.04至1.27 ）和1.14（95％CI 1.03至1.27），以GPS列出的烧伤，工作满意度和一般福祉的最不利的类别（最有利的类别）。由于车身护理敏感的条件的病症不同样相关。频率增加，GP精神福祉水平降低，工作满意度和自我额定的可加工性。这些发现意味着GPS的工作条件和心理健康可能对个体患者和医疗保健支出可能具有重要意义。

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