The Financial Impact of Burnout and Mental Health on Hospitalist Turnover and the Contribution of Work Structures and Environment

PROJECT SUMMARY/ABSTRACT Hospitals across the United States are increasingly relying on physicians and advanced practice providers who care for hospitalized patients (hospitalists). Hospitalists provide critical services and face a variety of stressors, including unprecedented work conditions, exposures to highly infectious diseases, high patient volumes, and

unpredictable work demands. These factors contribute to high levels of job stress, which in turn can lead to occupational burnout and mental health problems among hospitalists. In a recent single center study, 62% of hospitalists reported burnout, with workload being the most commonly cited factor. This is concerning because

of the high reliance on hospitalists and the links between burnout and poor mental health and suboptimal patient safety outcomes, and physician turnover. Burnout among US physicians has been estimated to cost the US society $4.6 billion annually and health care organizations $7,600 per employed physician each year. However,

existing research on factors contributing to burnout and the consequences of burnout are primarily based on physicians working in outpatient practices, leaving a critical gap in evidence-informed strategies to address burnout among hospitalists and a lack of understanding of the cost of burnout to hospitals. Additionally, there

have been even fewer studies focused on hospitalist mental health. There is an urgent need to address the issue burnout and poor mental health among hospitalists, as over one-third have considered leaving their current job, threatening the sustainability of the workforce. Hospitalist turnover not only affects the long-term viability of the

field, but also has the potential to incur substantial costs for healthcare organizations; however, the costs are not fully known. Determining the costs associated with hospitalist turnover is a crucial next step as it can inform organizational decisions about work structure and environment and ultimately improve the well-being and

resilience of hospitalists. We will utilize a prospective multi-measure design to assess prevalence of burnout and mental health and the relationship to hospitalist turnover using validated survey measures at 10 hospitals (Aim 1). Factors related to work structure and work environment that may contribute to burnout and poor mental health

among hospitalists will also be examined. We will gather data on the costs of hospitalist turnover by surveying hospitalist group leaders at the 10 sites to model the probability of turnover, exploring relationships with burnout, mental health status, and other covariates (Aim 2). A cost-consequence analysis will help leaders understand

the economic impact of turnover. The results of this study have the potential to inform policies and interventions aimed at improving hospitalist well-being and reducing burnout and turnover in a significant portion of the healthcare workforce. This is important because the results of this study will influence organizational decisions

about work structure and work environments that may be driving burnout and worsening mental health among hospitalists and serve as a blueprint for other specialties.