Evidence map›Paper›PMID 36697928›Full record

ArticleJournal of general internal medicine2023

Patient Enrollment Growth and Burnout in Primary Care at the Veterans Health Administration.

Allyson W O'Connor, Edwin S Wong, Karin M Nelson, Jeanne M Sears, Christian D Helfrich

Open access · bronzeAbstract read
In one paragraph

Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 2 countries.

Allyson W O'ConnorDepartment of Health Systems and Population Health, University of Washington, Seattle, WA, USA. awoconno@uw.edu.ORCID 0000-0001-8675-2235
Edwin S WongDepartment of Health Systems and Population Health, University of Washington, Seattle, WA, USA.
Karin M NelsonCenter for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA, USA.
Jeanne M SearsDepartment of Health Systems and Population Health, University of Washington, Seattle, WA, USA.
Christian D HelfrichDepartment of Health Systems and Population Health, University of Washington, Seattle, WA, USA.
University of Washington · US

Funding

University of Washington Education and Research CenterT42OH008433 · OH · UNIVERSITY OF WASHINGTON · PI SIMPSON, CHRISTOPHER D · 2005 to 2024
$29.4M
ACL HHS T42OH008433NIOSH CDC HHS T42 OH008433
6 · The paper itself

Abstract

backgroundPatient enrollment levels at Veterans Health Administration (VHA) facilities change based on Veteran demand for care, potentially affecting demands on staff. Effects on burnout in the primary care workforce associated with increases or decreases in enrollment are unknown.

objectiveEstimate associations between patient enrollment and burnout.

designIn this serial cross-sectional study, VHA patient enrollment and workforce data from 2014 to 2018 were linked to burnout estimates for 138 VHA facilities. The VHA's annual All Employee Survey provided burnout estimates.

participantsA total of 82,421 responses to the 2014-2018 All Employee Surveys by primary care providers (PCPs), including physicians, nurse practitioners, and physician assistants; nurses; clinical associates; and administrative clerks were included. Respondents identified as patient-aligned care team members. MAIN MEASURES: Independent variables were (1) the ratio of enrollment to PCPs at VHA facilities and (2) the year-over-year change in enrollment per PCP. Burnout was measured as the annual proportion of staff at VHA facilities who reported emotional exhaustion and/or depersonalization. Each primary care role was analyzed independently. KEY

resultsOverall enrollment decreased from 1553 enrollees per PCP in 2014 to 1442 enrollees per PCP in 2018 across VHA facilities. Forty-three facilities experienced increased enrollment (mean of 1524 enrollees/PCP in 2014 to 1668 in 2018) and 95 facilities experienced decreased enrollment (mean of 1566 enrollees/PCP in 2014 to 1339 in 2018). Burnout decreased for all primary care roles. PCP burnout was highest, decreasing from a facility-level mean of 51.7% in 2014 to 43.8% in 2018. Enrollment was not significantly associated with burnout for any role except nurses, for whom a 1% year-over-year increase in enrollment was associated with a 0.2 percentage point increase in burnout (95% CI: 0.1 to 0.3).

conclusionsStudies assessing changes in organizational-level predictors are rare in burnout research. Patient enrollment predicted burnout only among nurses in primary care.

Indexed as

Burnout, ProfessionalVeteransCross-Sectional StudiesHumansPrimary Health CareUnited StatesUnited States Department of Veterans AffairsVeterans Healthburnouthealthcarepatient panelprimary careworkload

Identifiers

PMID36697928
PMCPMC10212874
OpenAlexW4317989598

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.