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Koike S, Wada H, Ohde S, Ide H, Taneda K, Tanigawa T. Working hours of full-time hospital physicians in Japan: a cross-sectional nationwide survey. BMC Public Health 2024; 24:164. [PMID: 38216962 PMCID: PMC10785398 DOI: 10.1186/s12889-023-17531-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/19/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND The culture of excessively long overtime work in Japan has not been recently addressed. New legislation on working hours, including a limitation on maximum overtime work for physicians, will be enforced in 2024. This study was performed to elucidate the working conditions of full-time hospital physicians and discuss various policy implications. METHODS A facility survey and a physician survey regarding physicians' working conditions were conducted in July 2022. The facility survey was sent to all hospitals in Japan, and the physician survey was sent to all physicians working at half of the hospitals. The physicians were asked to report their working hours from 11 to 17 July 2022. In addition to descriptive statistics, a multivariate logistic regression analysis on the factors that lead to long working hours was conducted. RESULTS In total, 11,466 full-time hospital physicians were included in the analysis. Full-time hospital physicians worked 50.1 h per week. They spent 45.6 h (90.9%) at the main hospital and 4.6 h (9.1%) performing side work. They spent 43.8 h (87.5%) on clinical work and 6.3 h (12.5%) on activities outside clinical work, such as research, teaching, and other activities. Neurosurgeons worked the longest hours, followed by surgeons and emergency medicine physicians. In total, 20.4% of physicians were estimated to exceed the annual overtime limit of 960 h, and 3.9% were estimated to exceed the limit of 1860 h. A total of 13.3% and 2.0% exceeded this level only at their primary hospital, after excluding hours performing side work. Logistic regression analysis showed that male, younger age, working at a university hospital, working in clinical areas of practice with long working hours, and undergoing specialty training were associated with long working hours after controlling for other factors. CONCLUSIONS With the approaching application of overtime regulations to physicians, a certain reduction in working hours has been observed. However, many physicians still work longer hours than the designated upper limit of overtime. Work reform must be further promoted by streamlining work and task-shifting while securing the functions of university hospitals such as research, education, and supporting healthcare in communities.
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Affiliation(s)
- Soichi Koike
- Division of Health Policy and Management, Center for Community Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
| | - Hiroo Wada
- Department of Public Health, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Sachiko Ohde
- Graduate School of Public Health, St. Luke's International University, 3-6-2 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan
| | - Hiroo Ide
- Institute for Future Initiatives, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan
| | - Kenichiro Taneda
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
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Coelho J, Lucas G, Micoulaud-Franchi JA, Tran B, Yon DK, Taillard J, D'Incau E, Philip P, Boyer L, Fond G. Sleep timing, workplace well-being and mental health in healthcare workers. Sleep Med 2023; 111:123-132. [PMID: 37769583 DOI: 10.1016/j.sleep.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION Healthcare workers face an elevated risk of burnout, sleep disorders, and mental health issues, potentially stemming from the misalignment of their circadian rhythm due to nonstandard work schedules. This cross-sectional survey aims to examine the connections between sleep timing, workplace well-being (including burnout and absenteeism), and mental health outcomes (specifically depression and poor sleep) in healthcare workers. Additionally, the survey takes into account individual and professional factors, as well as the interaction with work schedules. METHODS The study encompasses 4,971 healthcare workers from both public and private healthcare facilities in France, including nurses, nursing assistants, and physicians recruited during the third wave of the COVID-19 pandemic. The Maslach Burnout Inventory assesses burnout, the Center for Epidemiologic Studies Depression Scale measures depression, and the Pittsburgh Sleep Quality Index evaluates poor sleep. Sleep timing is categorized into morning, neutral, and evening timing, referred to as midsleep. Multivariate logistic regression analysis is conducted to explore the relationships between sleep timing and burnout, depression, and poor sleep, while adjusting for various factors. RESULTS The findings reveal that 56.5% of participants experience burnout, 29.8% report depression, and 64.5% report poor sleep. Nurses and nursing assistants exhibit a higher prevalence of poor sleep. Morning sleep timing is associated with burnout among those with fixed schedules and with depression among those with shift schedules. Among physicians, both morning and evening sleep timing are associated with depression, while morning sleep timing is linked to poor sleep across all subgroups. INTERPRETATION This study suggests that the misalignment between healthcare workers' internal circadian rhythm and their work schedules may contribute to an increased risk of burnout, depression, and poor sleep. Occupational health services and policymakers should recognize the potential for enhancing workplace well-being and mental health outcomes by enabling healthcare workers to maintain sleep schedules that accommodate their needs.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Guillaume Lucas
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Bach Tran
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea; Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Jacques Taillard
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France
| | - Emmanuel D'Incau
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Pierre Philip
- Univ. Bordeaux, SANPSY, UMR 6033, F-33000, Bordeaux, France; CNRS, SANPSY, UMR 6033, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine du sommeil, F-33000, Bordeaux, France
| | - Laurent Boyer
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France
| | - Guillaume Fond
- Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, CEReSS-Health Service Research and Quality of Life Center, 27, boulevard Jean -Moulin, 13005, Marseille, France; Fondation FondaMental, Créteil, France.
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