Table.
Selected Physician, Team, and Hospital Characteristics and their Association with Reporting Unsafe Workload More Than Monthly
| Characteristic | Report of Unsafe Workload* | Univariate Odds Ratio (95% CI) |
Reported Effect on Unsafe Workload Frequency |
||
|---|---|---|---|---|---|
| Lower | Higher | ||||
| Percentage of total workhours devoted to patient care, median [IQR] | 95 [80, 100] | 100 [90, 100] | 1.13a (1.04, 1.23)§ | Increased | |
| Percentage of clinical care which is inpatient, median [IQR] | 75 [50, 85] | 80 [70, 90] | 1.21a (1.13, 1.34)‖ | ||
| Percentage of clinical work performed with no assistance from housestaff or midlevels, median [IQR] | 80 [25, 100] | 90 [50, 100] | 1.08a (1.03, 1.14)§ | ||
| Years in practice, median [IQR] | 6 [3, 11] | 5 [3, 10] | 0.85b (0.75, 0.98)† | Decreased | |
| Percentage of workday allotted for personal time, median [IQR] | 5 [0, 7] | 3 [0, 5] | 0.50a (0.38, 0.92)† | ||
| Systems for increased patient volume, No. (%) | Fixed census cap | 87 (30) | 45 (22) | 0.66 (0.43, 0.99)† | |
| Fixed bed capacity | 36 (13) | 24 (12) | 0.94 (0.54, 1.63) | ||
| Staffing augmentation | 88 (31) | 58 (29) | 0.91 (0.61, 1.35) | ||
| Any system | 217 (76) | 130 (64) | 0.58 (0.39, 0.86)‡ | ||
| Primary practice area of hospital medicine, No. (%) | Adult | 211 (73) | 173 (86) | 1 | Equivocal |
| Pediatric | 7 (2) | 1 (0.5) | 0.24 (0.03, 2.10) | ||
| Med/Peds | 5 (2) | 3 (1) | 0.73 (0.17, 3.10) | ||
| Primary role, No. (%) | Clinical | 242 (83) | 186 (92) | 1 | |
| Research | 5 (2) | 4 (2) | 1.04 (0.28, 3.93) | ||
| Administrative | 14 (5) | 6 (3) | 0.56 (0.21, 1.48) | ||
| Physician age, median [IQR], yrs | 36 [32, 42] | 37 [33, 42] | 0.96b (0.86, 1.07) | ||
| Compensation, median [IQR], thousands of dollars | Salary only | 180 [130, 200] | 180 [150, 200] | 0.97c (0.98, 1.05) | |
| Incentive pay only | 10 [0, 25] | 10 [0, 20] | 0.99c (0.94, 1.04) | ||
| Total | 190 [140, 220] | 196 [165, 220] | 0.99c (0.98, 1.03) | ||
| Practice area, No. (%) | Urban | 128 (45) | 98 (49) | 1 | |
| Suburban | 126 (44) | 81 (41) | 0.84 (0.57, 1.23) | ||
| Rural | 33 (11) | 21 (10) | 0.83 (0.45, 1.53) | ||
| Practice location, No. (%) | Academic | 82 (29) | 54 (27) | 1 | |
| Community | 153 (53) | 110 (55) | 1.09 (0.72, 1.66) | ||
| Veterans’ Hospital | 7 (2) | 4 (2) | 0.87 (0.24, 3.10) | ||
| Group | 32 (11) | 25 (13) | 1.19 (0.63, 2.21) | ||
| Physician group size, No. (%) | 12 [6, 20] | 12 [8, 22] | 0.99d (0.98, 1.03) | ||
| Localization of patients, No. (%) | Multiple units | 179 (61) | 124 (61) | 1 | |
| Single or adjacent unit(s) | 87 (30) | 58 (29) | 0.96 (0.64, 1.44) | ||
| Multiple hospitals | 25 (9) | 20 (10) | 1.15 (0.61, 2.17) | ||
*
Note: Not all response options shown. Columns may not add up to 100%.
Abbreviations: CI, confidence interval; IQR, interquartile range
a
Expressed per 10% increase in activity
b
Expressed per 5 additional years
c
Expressed per $10,000
d
Expressed per 5 additional physicians
†
p<0.05
‡
p<0.01
§
p<0.005
‖
p<0.001