Burnout Trends Among US Health Care Workers.

Importance: Burnout among health care workers is a widespread concern in health care both before and since the COVID-19 pandemic, yet little is known about health care workers' burnout levels across occupations and settings. Objective: To examine trends in burnout and professional stress reported among health care workers working at the US Veterans Health Administration (VHA) and identify occupations that experienced notable changes and the factors associated with changes. Design, Setting, and Participants: This survey study used a retrospective cohort design grouped by key factors associated with burnout and professional stress. Responses to an annual organization-wide survey at 140 medical centers from 2018 to 2023 were used. Exposures: Respondents self-reported on 2 burnout items (ie, "I feel burned out from my work" and "I worry that this job is hardening me emotionally") from the Maslach Burnout Inventory during all study years and professional stress (moderate or lower vs high or extreme) from COVID-19 from 2020 to 2023. Main Outcome and Measures: Trends by occupation, telework status, and geographic region were examined, as well as the general pattern over time and the change in burnout and stress rates in the years following the start of the pandemic. Results: In 2018, the sample was 71.6% female, with an estimated mean (SD) age of 46.31 (12.11) years, and estimated mean (SD) VA tenure of 8.54 (7.33) years. Totals of health care worker respondents identified from 140 medical centers ranged from 123 271 in 2018 to 169 448 in 2023. Annual burnout rates were 30.4% for 2018, 31.3% for 2019, 30.9% for 2020, 35.4% for 2021, 39.8% for 2022, and 35.4% for 2023. Rates of professional stress from COVID-19 were 32.0% for 2020, 26.9% for 2021, 29.2% for 2022, and 21.4% for 2023. Both measures showed a decrease following the official public health emergency ending in 2023. Primary care physicians reported the highest burnout levels compared with other service areas, ranging from 46.2% in 2018 to 57.6% in 2022. Several service areas saw a relative increase of 10% or more in burnout between 2018 and 2023, with mental health, dental, and rehabilitation service employees reporting the highest increases in burnout rates over this time. Burnout levels for respondents who teleworked most of the time were lower than those for respondents who did not telework. Conclusions and Relevance: In this survey study of VHA health care workers, burnout and professional stress decreased on average following the pandemic, but burnout levels remain elevated compared with prepandemic levels. The VHA has made several efforts to reduce burnout and stress, and results showed some promise, but exploration of ways to reduce burnout to prepandemic levels is needed.