IDEAS home Printed from https://ideas.repec.org/a/spr/aphecp/v18y2020i3d10.1007_s40258-019-00544-w.html
   My bibliography  Save this article

The Impact of Physicians’ Working Hours on Inappropriate Use of Outpatient Medicine in a Tertiary Hospital in China

Author

Listed:
  • Xiaodong Guan

    (Peking University
    Peking University
    Harvard Medical School and Harvard Pilgrim Health Care Institute)

  • Bingyu Ni

    (Peking University)

  • Jingyuan Zhang

    (Peking University)

  • Chunxia Man

    (Aerospace Center Hospital)

  • Zheng Cai

    (Peking University Third Hospital)

  • Wenshuang Meng

    (Capital Medical University)

  • Luwen Shi

    (Peking University
    Peking University)

  • Dennis Ross-Degnan

    (Harvard Medical School and Harvard Pilgrim Health Care Institute)

Abstract

Background Inappropriate prescribing is an important health system problem in China. Several studies have identified critical factors influencing prescription quality, but the impact of physicians’ working hours remains unknown. In China, tertiary hospitals face ever-increasing outpatient volumes. Physicians are asked to work long hours and the impact of shift duration on prescription quality is unknown. Objective We aimed to investigate the association between consecutive working hours and the quality of physicians’ prescriptions in a Chinese tertiary hospital. Methods We obtained all outpatient electronic health records from the hospital information system (HIS) of a tertiary hospital in Beijing, China from 1 July to 30 November 2015. Prescriptions made during two periods were analyzed: a morning shift from 7:30 to 12:30, and an afternoon shift from 13:30 to 18:30. The time when a physician issued the first prescription was considered the beginning of the work shift and prescriptions within the next 4 consecutive hours were included. Potentially inappropriate prescriptions were based on the Rational Drug Use (RDU) system that was developed and validated for this study. We used multivariable logistic regression to examine the impact of shift duration and other clinical and physician factors on potentially inappropriate prescribing. Results Of the total 560,529 prescriptions, 15.3% were classified as inappropriate by the RDU system. Physicians’ inappropriate prescribing increased in the last hour in each work shift (odds ratio (OR) for the fourth hour compared to the first = 1.12 (95% CI, 1.09–1.15)). We also found that physicians who worked all day had a higher rate of inappropriate prescribing than those who only worked half a day (OR = 1.05 (95% CI, 1.04–1.07)). Conclusions Longer working hours are a risk factor for inappropriate prescribing. Relevant interventions are urgently needed to establish working hour limits in China to reduce the likelihood of inappropriate prescribing by physicians.

Suggested Citation

  • Xiaodong Guan & Bingyu Ni & Jingyuan Zhang & Chunxia Man & Zheng Cai & Wenshuang Meng & Luwen Shi & Dennis Ross-Degnan, 2020. "The Impact of Physicians’ Working Hours on Inappropriate Use of Outpatient Medicine in a Tertiary Hospital in China," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 443-451, June.
    • Handle: RePEc:spr:aphecp:v:18:y:2020:i:3:d:10.1007_s40258-019-00544-w
    DOI: 10.1007/s40258-019-00544-w
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40258-019-00544-w
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40258-019-00544-w?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Marianna Virtanen & Stephen A Stansfeld & Rebecca Fuhrer & Jane E Ferrie & Mika Kivimäki, 2012. "Overtime Work as a Predictor of Major Depressive Episode: A 5-Year Follow-Up of the Whitehall II Study," PLOS ONE, Public Library of Science, vol. 7(1), pages 1-5, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 1st June 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-06-01 11:00:00

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Xiangdan Piao & Xinxin Ma & Chi Zhang & Shunsuke Managi, 2020. "Impact of Gaps in the Educational Levels between Married Partners on Health and a Sustainable Lifestyle: Evidence from 32 Countries," Sustainability, MDPI, vol. 12(11), pages 1-20, June.
    2. Robert Rudolf, 2014. "Work Shorter, Be Happier? Longitudinal Evidence from the Korean Five-Day Working Policy," Journal of Happiness Studies, Springer, vol. 15(5), pages 1139-1163, October.
    3. Florian Junne & Martina Michaelis & Eva Rothermund & Felicitas Stuber & Harald Gündel & Stephan Zipfel & Monika A. Rieger, 2018. "The Role of Work-Related Factors in the Development of Psychological Distress and Associated Mental Disorders: Differential Views of Human Resource Managers, Occupational Physicians, Primary Care Phys," IJERPH, MDPI, vol. 15(3), pages 1-17, March.
    4. Sato, Kaori & Kuroda, Sachiko & Owan, Hideo, 2020. "Mental health effects of long work hours, night and weekend work, and short rest periods," Social Science & Medicine, Elsevier, vol. 246(C).
    5. Sachiko Kuroda & Isamu Yamamoto, 2019. "Why Do People Overwork at the Risk of Impairing Mental Health?," Journal of Happiness Studies, Springer, vol. 20(5), pages 1519-1538, June.
    6. Eva Urbón & Carlos Salavera, 2023. "Emotional Education as Coping Strategy for Exhaustion and Dysfunctional Eating Habits," Social Sciences, MDPI, vol. 12(8), pages 1-12, August.
    7. Moeller, Julia & Ivcevic, Zorana & White, Arielle E. & Menges, Jochen & Brackett, Marc A., 2018. "Highly Engaged but Burned Out: Intra-Individual Profiles in the US Workforce," OSF Preprints h6qnf, Center for Open Science.
    8. Hiroyuki Kikuchi & Yuko Odagiri & Yumiko Ohya & Yutaka Nakanishi & Teruichi Shimomitsu & Töres Theorell & Shigeru Inoue, 2020. "Association of overtime work hours with various stress responses in 59,021 Japanese workers: Retrospective cross-sectional study," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-22, March.
    9. Rubia R. Valente & Brian J. L. Berry, 2017. "Acculturation of Immigrant Latinos into the U.S. Workplace: Evidence from the Working Hours-life Satisfaction Relationship," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 12(2), pages 451-479, June.
    10. Aurora B. Le & Abdulrazak O. Balogun & Todd D. Smith, 2022. "Long Work Hours, Overtime, and Worker Health Impairment: A Cross-Sectional Study among Stone, Sand, and Gravel Mine Workers," IJERPH, MDPI, vol. 19(13), pages 1-9, June.
    11. Lee, Jungmin & Lee, Yong-Kwan, 2016. "Can working hour reduction save workers?," Labour Economics, Elsevier, vol. 40(C), pages 25-36.
    12. KURODA Sachiko & YAMAMOTO Isamu, 2016. "Workers' Mental Health, Long Work Hours, and Workplace Management: Evidence from workers' longitudinal data in Japan," Discussion papers 16017, Research Institute of Economy, Trade and Industry (RIETI).
    13. Robyn Considine & Ross Tynan & Carole James & John Wiggers & Terry Lewin & Kerry Inder & David Perkins & Tonelle Handley & Brian Kelly, 2017. "The Contribution of Individual, Social and Work Characteristics to Employee Mental Health in a Coal Mining Industry Population," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-15, January.
    14. Ayako Hino & Akiomi Inoue & Kosuke Mafune & Mayumi Tsuji & Seiichiro Tateishi & Akira Ogami & Tomohisa Nagata & Keiji Muramatsu & Yoshihisa Fujino & on behalf of The CORoNaWork Project, 2022. "Association between Long Working Hours and Psychological Distress: The Effect Modification by Request to Stay Home When Sick in the Workplace during the COVID-19 Pandemic," IJERPH, MDPI, vol. 19(7), pages 1-10, March.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:aphecp:v:18:y:2020:i:3:d:10.1007_s40258-019-00544-w. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.