1. Does Mental Health Care Integration Affect Primary Care Clinician Burnout? Results from a Longitudinal Veterans Affairs Survey
- Author
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Leung, Lucinda B, Rose, Danielle, Rubenstein, Lisa V, Guo, Rong, Dresselhaus, Timothy R, and Stockdale, Susan
- Subjects
Health Services and Systems ,Health Sciences ,Behavioral and Social Science ,Mental Health ,Clinical Research ,Health Services ,Mental health ,Good Health and Well Being ,Burnout ,Professional ,Cross-Sectional Studies ,Humans ,Job Satisfaction ,Primary Health Care ,Surveys and Questionnaires ,United States ,United States Department of Veterans Affairs ,Veterans ,burnout ,primary care ,mental health ,communication ,veterans ,Clinical Sciences ,General & Internal Medicine ,Clinical sciences ,Health services and systems ,Public health - Abstract
BackgroundBurnout among primary care clinicians (PCPs) is associated with negative health and productivity consequences. The Veterans Health Administration (VA) embedded mental health specialists and care managers in primary care to manage common psychiatric diseases. While challenging to implement, mental health integration is a team-based care model thought to improve clinician well-being.ObjectiveTo examine the relationships between PCP-reported burnout (and secondarily, job satisfaction) and mental health integration at provider and clinic levels DESIGN: Analysis of 286 cross-sectional surveys in 2012 (n = 171) and 2013 (n = 115) PARTICIPANTS: 210 PCPs in one VA region MAIN MEASURES: Outcomes were PCP-reported burnout (Maslach Burnout Inventory emotional exhaustion subscale), and secondarily, job satisfaction. Two independent variables represented mental health integration: (1) PCP-specialty communication rating and (2) proportion of clinic patients who saw integrated specialists. Using multilevel regression models, we examined PCP-reported burnout (and job satisfaction) and mental health integration, adjusting for PCP characteristics (e.g., gender), PCP ratings of team functioning (communication, knowledge/skills, satisfaction), and organizational factors.Key resultsOn average, PCPs reported high burnout (29, range = 9-54) across all VA healthcare systems. In total, 46% of PCPs reported "very easy" communication with mental health; 9% of primary clinic patients had seen integrated specialists. Burnout was not significantly associated with mental health communication ratings (β coefficient = - 0.96, standard error [SE] = 1.29, p = 0.46), nor with proportion of clinic patients who saw integrated specialists (β = 0.02, SE = 0.11, p = 0.88). No associations were observed with job satisfaction either. Among study participants, PCPs with poor team functioning, as exhibited by low team communication ratings, reported high burnout (β = - 1.28, SE = 0.22, p
- Published
- 2020