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Contextual Factors Associated with Burnout among Chinese Primary Care Providers: A Multilevel Analysis

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  • Huiwen Li

    (School of Public Health, Peking University, Beijing 100191, China
    China Center for Health Development Studies, Peking University, Beijing 100191, China
    Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA)

  • Beibei Yuan

    (China Center for Health Development Studies, Peking University, Beijing 100191, China)

  • Qingyue Meng

    (School of Public Health, Peking University, Beijing 100191, China
    China Center for Health Development Studies, Peking University, Beijing 100191, China)

  • Ichiro Kawachi

    (Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA)

Abstract

Burnout is a common and growing phenomenon in the health care setting. The objective of the present study is to examine contextual factors in the workplace associated with burnout among primary care providers (PCPs) in Shandong Province, China. A cross-sectional survey was conducted among 951 PCPs nested within 48 primary health institutions (PHIs). Burnout was measured using the Maslach Burnout Inventory–Human Services Survey (MBI–HSS). We used two-level random intercept linear regression models to examine individual- versus workplace-level risk factors for burnout. The result revealed that 33.12%, 8.83% and 41.43% PCPs were experiencing a high degree of emotional exhaustion (EE), depersonalization (DP) and low personal accomplishment (PA). In multilevel analysis, the most significant and common individual-level predictors of burnout were lack of perceived work support and autonomy. At the institutional level, workload was positively related to EE (odds ratio (OR): 6.59; 95% confidence interval (CI): 3.46–9.72), while work support was related to higher PA (OR: 3.49; 95% CI: 0.81–6.17). Greater attention should be paid to the influence of the work environment factors (workload and work support) to prevent burnout. Strategies such as increasing human resources allocated to PHIs and establishing a supportive work environment are encouraged to prevent and reduce burnout among PCPs in China.

Suggested Citation

  • Huiwen Li & Beibei Yuan & Qingyue Meng & Ichiro Kawachi, 2019. "Contextual Factors Associated with Burnout among Chinese Primary Care Providers: A Multilevel Analysis," IJERPH, MDPI, vol. 16(19), pages 1-12, September.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:19:p:3555-:d:269761
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    References listed on IDEAS

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    1. Huazhang Li & Kun Liu & Jianjun Gu & Yimin Zhang & Yun Qiao & Xiaoming Sun, 2017. "The development and impact of primary health care in China from 1949 to 2015: A focused review," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(3), pages 339-350, July.
    2. Zhou, Xu Dong & Li, Lu & Hesketh, Therese, 2014. "Health system reform in rural China: Voices of healthworkers and service-users," Social Science & Medicine, Elsevier, vol. 117(C), pages 134-141.
    3. Ehsan Zarei & Fariba Ahmadi & Muhammad Safdar Sial & Jinsoo Hwang & Phung Anh Thu & Sardar Muhammad Usman, 2019. "Prevalence of Burnout among Primary Health Care Staff and Its Predictors: A Study in Iran," IJERPH, MDPI, vol. 16(12), pages 1-10, June.
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    Cited by:

    1. Hao Zhou & Xinyi Sheng & Yulin He & Xiaoye Qian, 2020. "Ethical Leadership as the Reliever of Frontline Service Employees’ Emotional Exhaustion: A Moderated Mediation Model," IJERPH, MDPI, vol. 17(3), pages 1-13, February.
    2. Xinyi Zhao & Shu Liu & Yifan Chen & Quan Zhang & Yue Wang, 2021. "Influential Factors of Burnout among Village Doctors in China: A Cross-Sectional Study," IJERPH, MDPI, vol. 18(4), pages 1-10, February.
    3. Wanchun Xu & Zijing Pan & Zhong Li & Shan Lu & Liang Zhang, 2020. "Job Burnout Among Primary Healthcare Workers in Rural China: A Multilevel Analysis," IJERPH, MDPI, vol. 17(3), pages 1-18, January.
    4. Kaili Zhong & Lv Chen & Sixiang Cheng & Hongjun Chen & Fei Long, 2020. "The Efficiency of Primary Health Care Institutions in the Counties of Hunan Province, China: Data from 2009 to 2017," IJERPH, MDPI, vol. 17(5), pages 1-15, March.
    5. Song Liu & Hao Zhou, 2020. "The Role of Sense of Power in Alleviating Emotional Exhaustion in Frontline Managers: A Dual Mediation Model," IJERPH, MDPI, vol. 17(7), pages 1-16, March.

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