Physicians’ Workloads in China: 1998–2016

Fu, Yanhong; Schwebel, David C.; Hu, Guoqing

doi:10.3390/ijerph15081649

Cited by 46 publications

(44 citation statements)

References 13 publications

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“…6 Physician workload increased dramatically for Chinese physicians in the past 20 years. 15 Compared with physicians in other hospitals, Chinese physicians in tertiary hospitals bear heavier workload, physical and mental stress. 16 The specific work of reporting ADEs in Chinese medical institutions is generally carried out by clinical pharmacists.…”

Section: Discussionmentioning

confidence: 99%

Analysis of a pharmacist-led adverse drug event management model for pharmacovigilance in an academic medical center hospital in China

He¹,

Yao²,

Hu³

et al. 2018

TCRM

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BackgroundSpontaneous reporting of adverse drug events (ADEs) has long been the cornerstone of pharmacovigilance. Medical institutions in China have been a major source of ADE case reports, but the proportion of reports from tertiary hospitals is low due to the serious underreporting of case reports. The same problem existed in the Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU).ObjectiveIn order to increase the number of ADE reports and promote hospital pharmacovigilance, SAHZU’s clinical pharmacists established a pharmacist-led ADE management model. The aim of this paper is to introduce this management model and explore the advantages and disadvantages of the model.MethodsPharmacist-led ADE management model was gradually formed from 2015 to 2017 in the SAHZU. This “pharmacist-led” model is reflected not only in the fact that clinical pharmacists are the main reporters of SAHZU’s ADEs but also in that they are the main groups to analyze and manage ADE and drug errors. The sources of ADEs reported by clinical pharmacists mainly include pharmacy rounds, ADE-related pharmacist consultations, centralized monitoring, ADE warning signal analysis, newly introduced drug evaluations, and drug safety research.ResultsA total of 533 ADEs were reported by SAHZU to China’s spontaneous reporting system (SRS) in 2017, while the data in 2012 was 177, with an increase by 201%. In 2012, the proportion of “new” and “serious” reports was 16.4%. The proportions during the period from 2015 to 2017 were 41.4%, 60.8%, and 52.2%, respectively, which were statistically significant compared with the proportion in 2012. The proportion of ADEs reported by clinical pharmacists during the period from 2014 to 2017 were 51.5%, 57.3%, 68.8%, and 90.8%, respectively, which were statistically significant compared with the proportion in 2013 (P<0.05). There was a correlation between the proportions of severe ADEs and the proportion of ADEs reported by clinical pharmacists (r=0.873, P=0.023). Four hundred eighty four ADE cases reported by clinical pharmacists to China’s SRS in 2017 were mainly found in rounds of clinical pharmacists (74.17% [359/484]).ConclusionThe pharmacist-led pharmacovigilance working model significantly increased the quantity and quality of ADE reporting in SAHZU and promoted pharmacovigilance. This model is worth developing in Chinese tertiary hospitals and the following hospitals, where the physicians working there spend little time and energy on ADE reporting or the cost of physicians is high, while the clinical pharmacist team has strong professional skills.

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Section: Discussionmentioning

confidence: 99%

Analysis of a pharmacist-led adverse drug event management model for pharmacovigilance in an academic medical center hospital in China

He¹,

Yao²,

Hu³

et al. 2018

TCRM

View full text Add to dashboard Cite

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“…The health workers in China were also experiencing the increased workload due to the soaring demand for health service and the shortage of health workforce. The number of physicians in China increased by 60% in the past two decades, but the number of patient visits and the inpatient admissions increased by 276% and 355% in the meantime [13]. It was reported in the previous studies that the prevalence of burnout among doctors in China ranged from 66.5% to 87.8%; young doctors and doctors working in general hospitals are found to be at higher risk of burnout [2].…”

Section: Introductionmentioning

confidence: 96%

Job Burnout Among Primary Healthcare Workers in Rural China: A Multilevel Analysis

Pan

et al. 2020

IJERPH

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The health workers in rural primary care systems are at the increasing risk of job burnout. To explore the prevalence and associated factors of the job burnout among the primary healthcare worker in rural China, a cross-sectional survey was conducted among 15,627 participants in 459 township hospitals from six provinces. A combination of stratified multi-stage sampling and cluster sampling method, and a self-administrated questionnaire with the Chinese version of the Maslach Burnout Inventory-General Scale (MBI-GS) were used in the investigation. Multilevel regression analyses were used to examine the potential associated factors on both individual and organisational levels. 47.6% of respondents were experiencing moderate burnout, and 3.3% were in severe burnout. Professionals working for over 40 h per week, at young age, with a college degree, and with professional titles at medium or high rank reported a higher degree of job burnout. At the institutional level, the high ratio of performance-based salary was associated with a higher level of depersonalization. Burnout has become prevalent among the primary healthcare workers in rural China, and multiple strategies are needed to reduce the work stress and some high-risk groups’ vulnerability to job burnout.

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“…According to the statistics from the National Health and Family Planning Commission of China, of the 2.6 billion outpatient visits to hospitals from January to November 2014, 46% were received by tertiary hospitals [16]. It was reported that 72.43% of medical doctors employed by tertiary hospitals in China worked over 60 hours per week (Chinese Medical Doctor Association 2015) [25], way beyond the legal limit of 44 hours [26].…”

Section: Introductionmentioning

confidence: 99%

Work-Related Accumulated Fatigue among Doctors in Tertiary Hospitals: A Cross-Sectional Survey in Six Provinces of China

Tang

Liu

Fang

et al. 2019

IJERPH

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Objectives: “Karoshi” (death due to overwork) of doctors occurred frequently and attracted increasing attention in recent years in China. This study aimed to determine the prevalence of work-related accumulated fatigue of doctors and its associated factors in tertiary hospitals of China. Methods: A cross-sectional questionnaire survey was conducted on 1729 full-time doctors employed by 24 tertiary hospitals across eastern developed, central developing, and western underdeveloped regions of China. Accumulated fatigue was categorized into four levels using the “Self-diagnosis Checklist for Assessment of Workers’ Accumulated Fatigue” rated on a scale matrix considering both overwork and fatigue symptoms. Ordinal logistic regression analyses were performed to identify factors associated with work-related accumulated fatigue. Results: About 78.8% of respondents reported a “high level” of work-related accumulated fatigue, including 42.0% at a “very high” level. Male doctors and those aged between 30 and 45 years and who had a professional title were found to have higher levels of accumulative fatigue than others. Low salary and poor working conditions (in the western region) were also significantly associated with high levels of work-related accumulated fatigue (p < 0.05). Conclusion: High levels of work-related accumulated fatigue are prevalent in doctors working in tertiary hospitals in China. Male doctors establishing their early- and mid-careers are the high-risk group. Poor working conditions are associated with work-related accumulated fatigue.

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Physicians’ Workloads in China: 1998–2016

Cited by 46 publications

References 13 publications

Analysis of a pharmacist-led adverse drug event management model for pharmacovigilance in an academic medical center hospital in China

Analysis of a pharmacist-led adverse drug event management model for pharmacovigilance in an academic medical center hospital in China

Job Burnout Among Primary Healthcare Workers in Rural China: A Multilevel Analysis

Work-Related Accumulated Fatigue among Doctors in Tertiary Hospitals: A Cross-Sectional Survey in Six Provinces of China

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