Objective

To study the relationship between occupational distress and sleep-related impairment in physicians and unsolicited patient complaints.

Participants and Methods

We used deidentified data from an academic medical center’s physician survey administered in April and May of 2013 to perform a retrospective cohort study. Third-party stewards of the identifiable information regarding unsolicited patient complaints from January 1, 2013, through December 31, 2016, matched these data with corresponding physicians’ occupational distress data. Unsolicited patient complaints were used to calculate the Patient Advocacy Reporting System (PARS) score, a validated predictor of malpractice litigation risk and clinical outcomes. Physicians were grouped into 1 of 3 PARS risk categories based on previously defined thresholds: low risk (score of 0), intermediate risk (score of 1-12), or high risk (score ≥13).

Results

Each 1-point increase in burnout and sleep-related impairment, on a 5-point scale, was associated with a 69% (odds ratio [OR], 1.69; 95% CI, 1.12-2.54) and 49% (OR, 1.49; 95% CI, 1.08-2.05) increased odds of being in the next higher PARS risk category, respectively, averaged across all 4 years. Professional fulfillment was a protective factor, associated with fewer unsolicited patient complaints. Each 1-point decrease in professional fulfillment was associated with a 68% (OR, 1.68; 95% CI, 1.16-2.44) increased odds of being in the next higher PARS risk category. The effect of depression on PARS risk category was not significant (OR, 1.33; 95% CI, 0.84-2.10).

Conclusion

Findings from this research suggest that occupational distress and sleep-related impairment in physicians are associated with unsolicited patient complaints.

中文翻译：

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职业病和睡眠相关障碍的医师与未经请求的患者投诉的关系。

目的

研究医生的职业困扰与睡眠相关障碍与患者主动投诉之间的关系。

参加者和方法

我们使用来自2013年4月和5月进行的学术医学中心医师调查的不确定数据来进行回顾性队列研究。从2013年1月1日到2016年12月31日，第三方管理者针对未经请求的患者投诉提供了可识别的信息，并将这些数据与相应的医生的职业困扰数据进行了匹配。未经请求的患者投诉用于计算患者权益报告系统（PARS）得分，该得分是不良行为诉讼风险和临床结果的有效预测指标。根据先前定义的阈值，将医生分为3种PARS风险类别中的1种：低风险（0分），中度风险（1-12分）或高风险（≥13分）。

结果

疲劳和与睡眠相关的障碍每增加1点，即5点，分别与69％（优势比[OR]，1.69； 95％CI，1.12-2.54）和49％（OR，1.49）相关； 95％CI（1.08-2.05）分别增加了所有4年的平均水平，成为更高PARS风险类别的几率。专业成就感是一个保护因素，与较少的患者主动投诉相关。专业成就每降低1点，则下一个较高的PARS风险类别中的几率增加68％（OR，1.68； 95％CI，1.16-2.44）。抑郁症对PARS风险类别的影响不显着（OR为1.33； 95％CI为0.84-2.10）。

结论

这项研究的发现表明，医生的职业困扰和与睡眠有关的损伤与患者主动提出投诉有关。