Background: It is necessary to examine doctors working with illness from a professional point of view, because it is not only related to their occupational health, but more importantly, will affect the treatment effect of patients and the overall medical level of the hospital. The purpose of this study was to explore the relationship between doctors' presenteeism and job burnout, and to identify other factors that are associated with presenteeism. Methods: A cross-sectional survey involving doctors (except for primary doctors) was conducted in China. Using one item measure about presenteeism and a 15-item Chinese version of the BMI-GS questionnaire, this study investigated prevalence of doctors' presenteeism and job burnout, and determined the relationship between presenteeism and job burnout by logistical model. Results: Relationship between presenteeism and job burnout were explored, and the influence of work factors were evaluated. The survey was completed by 1376/1547 hospital doctors, with a response rate of 88.9%. Presenteeism was reported by 30.7% of participants. Using MBI-GS, 86.8% of all doctors had moderate job burnout and 6.0%(n = 82) were severe job burnout. Logistic regression analysis showed that doctors with medium, high degree of emotional exhaustion and high degree of cynicism were more likely to practice presenteeism (all p < 0.05). In addition, two other work-related factors, including the doctors' department and position, were also likely to relate with presenteeism (all p < 0.05). Conclusions: By examining the relationship between presenteeism and job burnout, this study determined that there is indeed a significant correlation between the two. This result has a certain reference value for the development of work health, especially presenteeism and job burnout theory, and also makes a certain contribution to the relevant research literature.

Background: Primary health care (PHC) is a key component of the health care system in many countries. In China, however, PHC institutions are less preferred by patients, leading to the underuse of PHC services. Factors affecting patients' preferences for PHC institutions in China remain unreported in the current literature, which was first explored in this study. Method: A qualitative interview study was conducted in Nanjing, Jiangsu Province of China. A semi-structured interview guide was applied to ask patients' opinions regarding the PHC institutions in China. Qualitative data analysis was conducted using the thematic framework approach. Results: A total of 142 participants were interviewed. Three themes and their sub-themes emerged from the study: (1) attributes of PHC services, including accessibility of primary healthcare services, consultation time, drug cost, continuity of care, referral system, opening hours, waiting time, and drug accessibility; (2) attributes of PHC doctors' workforce, including doctors' attitude, competence, and accessibility; (3) attributes of PHC facility infrastructure, including basic facilities, diagnostic facilities and department settings. It was identified that some attributes of PHC services had positive impacts on participants' preferences for PHC institutions, while the same attributes of PHC doctors were the opposite. Conclusion: There are three major factors that contribute to patients' preferences for PHC institutions in China. Policy interventions to improve doctors' workforce and facility infrastructure of PHC institutions are needed to promote patients' preferences for PHC.

Background: With the aging population and increasing prevalence of chronic disease, the number of primary health care physicians in China is inadequate and physicians' turnover intention is too high. Objective: To analyze the status of primary health care physicians' turnover intention in China and the relationship between physicians' perceived overqualification and their turnover intention. Methods: With multistage stratified sampling, we randomly selected 1456 primary health care physicians as study subjects. Information on personal characteristics, job satisfaction, working pressure, turnover intention, and perceived overqualification was collected. The data were analyzed using descriptive statistics and multiple regression analysis. Results: We found that primary health care physicians in China have high turnover intention and perceived overqualification is positively related to turnover intention. Conclusion: Government and primary health care may address perceived overqualification to reduce physicians' turnover intention.

ObjectivesThe impact of presenteeism on doctors’ health, quality of patient care and overall performance of health institutions has been reported. The study aimed to investigate the prevalence of presenteeism among doctors, the association between presenteeism and anxiety/depression, and aspects that can help alleviate presenteeism.DesignA cross-sectional anonymous survey study was conducted between 2017 and 2018.Setting30 hospitals in Hangzhou city, Zhejiang Province, China including 10 category 1 hospitals (20–99 beds), 10 category 2 hospitals (100–499 beds) and 10 category 3 hospitals (> 500 beds) which had the highest population coverage.ParticipantsAt least 3 doctors from each department in the studied hospitals participated. Each participant received a gift worth around US$5 at completion of the survey.Primary and secondary outcome measuresThe prevalence of presenteeism and its relationship with anxiety or depression were evaluated as the primary outcomes. Secondary outcomes included the prevalence of abnormal cases of anxiety and depression.ResultsThe survey was completed by 1153/1309 hospital doctors (response rate 88.1%). Presenteeism was reported by 66.4% of participants. Using the Hospital Anxiety and Depression Scale, 68.8% and 72.3% of participants had abnormal cases of anxiety and depression, respectively. Logistic regression analysis showed that participants with abnormal cases of anxiety, borderline cases of depression or abnormal cases of depression were more likely to practice presenteeism (all p<0.05). Other significant work-related contributing factors included: time working at the current hospital, management duty, monthly salary and ease of replacement (all p<0.05).ConclusionPresenteeism was prevalent among doctors in China and the association of presenteeism with abnormal cases of anxiety or depression was significant. Considering the modifiable work-related contributing factors, appropriate measures at the healthcare institutions to support doctors’ mental health, help them develop and reinforce management skills, and ensure appropriate manpower are important to alleviate presenteeism behaviour.

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