engleski

Burnout in general practitioners in Croatia – does it affect interpersonal quality of care?

Background and aim. Burnout is a psychological syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment. The impact of physician burnout on quality of care is not clear. Our study aimed to investigate the prevalence of burnout in general practitioners (GPs) in Croatia and its association with patient enablement as a consultation outcome measure. Methods. A cross-sectional questionnaire- based study was performed from November 2003 to March 2004. We collected a national stratified random sample of 350 GPs, who were asked to collect data on 50 consecutive consultations with their patients aged 18 years or more. Patients provided data on patient enablement (Patient Enablement Instrument, score range 0-12). Physicians provided data on consultation length, age, sex, working experience, working conditions, job satisfaction and burnout (Maslach Burnout Inventory (MBI-HSS)). MBI-HSS scores were analyzed in the three dimensions of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). Mean patient enablement score and mean consultation length were calculated for individual physicians. Results. In 125 responding physicians (response rate 35.7%), 42.4% of physicians scored high for EE burnout, 16.0% for DP and 15.2% for PA burnout, with 4.0% scoring high burnout in all three dimensions. Mean patient enablement scores per physician ranged from 3.2 to 9.6 (mean 6.7, SD 1.2) and mean consultation length per physician ranged from 4.8 to 22.4 minutes (mean 11.6, SD 3.3). Linear regression analysis showed that low job satisfaction was predictor of high emotional exhaustion scores (b = -4.742, p<0.0001), more years working in current position (b = 0.166, p=0.032), more patients on the list (b = 0.003, p=0.038) and low job satisfaction (b = -0.591, p=0.039) were predictors of high depersonalisation scores, and less years working in current position (b = -0.238, p=0.016) and longer consultation (b = 0.385, p=0.018) were predictors of high personal accomplishment scores, respectively. Conclusion. Burnout rates in GPs in Croatia were low to moderate and comparable to studies in other European countries. Presence of burnout in physicians was not associated to patient enablement, suggesting that physician burnout did not affect the quality of interpersonal care.

Burnout; quality of care; family medicine

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