Relationship between care of patients with COVID-19 and burnout in resident physicians
| n | Burnout (%) | aPR* | 95% CI | P value | ||
| Lower limit | Upper limit | |||||
| Prefecture information | ||||||
| Population | ||||||
| Quartile 1 (573 441–1 786 170) | 1513 | 303 (20.0) | 1 (reference) | |||
| Quartile 2 (1 815 865–3 700 305) | 1401 | 324 (23.1) | 1.27 | 1.01 | 1.59 | 0.03 |
| Quartile 3 (5 101 556–7 483 128) | 1507 | 308 (20.4) | 1.06 | 0.82 | 1.37 | 0.66 |
| Quartile 4 (8 839 469–13 515 271) | 1555 | 342 (22.0) | 1.16 | 0.90 | 1.50 | 0.24 |
| High incidence area of COVID-19† | ||||||
| No | 1332 | 280 (21.0) | 1 (reference) | |||
| Yes | 4644 | 997 (21.5) | 0.92 | 0.73 | 1.16 | 0.47 |
| Hospital information | ||||||
| Type of hospital | ||||||
| Community-based hospital | 4996 | 1048 (21.0) | 1 (reference) | |||
| University branch hospital | 306 | 70 (22.9) | 1.04 | 0.77 | 1.41 | 0.78 |
| University hospital | 674 | 159 (23.6) | 1.04 | 0.86 | 1.26 | 0.67 |
| Category of infectious disease designated medical institution | ||||||
| Designated medical institution for infectious disease | 2487 | 545 (21.9) | 1 (reference) | |||
| Non-designated medical institution for infectious disease | 3489 | 732 (21.0) | 0.95 | 0.83 | 1.07 | 0.38 |
| Resident information | ||||||
| Sex | ||||||
| Male | 4064 | 908 (22.3) | 1 (reference) | |||
| Female | 1912 | 369 (19.3) | 0.85 | 0.77 | 0.94 | 0.001 |
| Grade | ||||||
| PGY-1 | 3041 | 691 (22.7) | 1 (reference) | |||
| PGY-2 | 2935 | 586 (20.0) | 0.87 | 0.79 | 0.95 | 0.002 |
| Emergency department duty | ||||||
| 0 per month | 220 | 58 (26.4) | 1 (reference) | |||
| 1–2 per month | 909 | 218 (24.0) | 0.85 | 0.60 | 1.19 | 0.33 |
| 3–5 per month | 4205 | 843 (20.1) | 0.70 | 0.51 | 0.96 | 0.02 |
| >6 per month | 611 | 149 (24.4) | 0.86 | 0.61 | 1.22 | 0.39 |
| Unknown | 31 | 9 (29.0) | 0.97 | 0.52 | 1.80 | 0.91 |
| Care of patients with COVID-19 | ||||||
| No experience with care of patients with COVID-19 | 759 | 162 (21.3) | 1 (reference) | |||
| Moderate experience with care of patients with COVID-19 (1–10) | 4273 | 894 (20.9) | 0.99 | 0.89 | 1.11 | 0.89 |
| Well experience with care of patients with COVID-19 (≥11 patients) | 944 | 221 (23.4) | 1.25 | 1.02 | 1.53 | 0.03 |
| PPE supply status | ||||||
| Sufficient supply | 5017 | 1011 (20.2) | 1 (reference) | |||
| Intermediate supply | 611 | 157 (25.7) | 1.31 | 1.15 | 1.51 | <0.001 |
| Insufficient supply | 348 | 109 (31.3) | 1.60 | 1.36 | 1.88 | <0.001 |
| Duty hour | ||||||
| 0–59 hours per week | 2517 | 520 (20.7) | 1 (reference) | |||
| 60–79 hours per week | 2264 | 471 (20.8) | 1.01 | 0.90 | 1.12 | 0.92 |
| >80 hours per week | 1195 | 286 (23.9) | 1.11 | 0.97 | 1.28 | 0.14 |
*Adjusted for all variables listed in the table using the multivariable modified Poisson regression model with cluster-robust variance.
†High incidence area of COVID-19 was defined as prefectures designated as endemic or non-endemic areas by setting the median of the cumulative number of patients with COVID-19 between 1 April 2020 and 31 January 2021 as the cut-off value.
aPR, adjusted prevalence ratio; PGY, postgraduate year; PPE, personal protective equipment.