Association of GP wellbeing and burnout with patient safety in UK primary care: a cross-sectional survey

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Figure 1.
Occupational variables, wellbeing, and near misses. b = unstandardised beta. ^aP<0.01. ^bP<0.001. GHQ = general health questionnaire.
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Figure 2.
Occupational variables, burnout, and safe practitioner. b = unstandardised beta. ^aP<0.05. ^bP<0.01. ^cP<0.001.
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Figure 3.
Occupational variables, exhaustion, and safe practitioner. b = unstandardised beta. ^aP<0.001.

Table 1.

Descriptive statistics

Variable	N^a	Mean (SD)	Range	Frequencies, n (%)
Age^a	223	47.86 (10.691)	27–66
Sex	227			Female, n = 135 (59.5), male, n = 89 (39.2), undisclosed, n = 3, (1.3)
Years in practice	227	17.97 (9.841)	0–55
Job role	227			Partner, n = 157 (69.2), locum, n = 12 (5.3), salaried, n = 41 (18.1), other, n = 13 (for example, in training) (5.7), undisclosed, n = 4, (1.8)
Practice location	227			Urban, n = 81, (35.7), suburban, n = 97 (42.7), rural, n = 36 (15.9), mixed, n = 13 (5.7)
Patient contact hours per week	227	23.278 (10.09)	0–50
Patients seen per day	222	32.77 (7.963)	9–51
Extra roles per week^a	214	4.322 (6.524)	0–35
Admin hours per week	227	11.850 (7.579)	0–36
Antisocial hours per week	227	9.22 (6.153)	0–36
On call per month^a	214	21.63 (28.339)	0–160
Supportive practice	227	6.33 (2.575)	0–10
Safe practice	227	2.26 (1.188)	0–4
Quality of life	227	5.80 (2.02)	0–10
GHQ-12^a	223	7.91 (2.605)	0–12	Possible case, n = 209, (93.72), no case, n = 14, (6.28)
OLBI: E^a	222	23.98 (3.952)	13–32	None, n =12, (5.41), mild, n = 48, (21.62), severe, n = 162, (72.97)
OLBI: D^a	224	21.48 (3.582)	13–32	None, n = 29 (12.95), mild, n = 84 (37.50), severe, n = 111 (49.55)
OLBI:^a total score	220	45.47 (6.729)	28–64
Adverse events	227			≥1, n = 36 (15.9), 0, n = 190 (83.7), missing data, n = 1 (0.4)
Near miss	227			≥1, n = 100 (44.1), 0, n =127 (55.9)

↵a Figures reported in Table 1 are prior to missing data being imputed, whereas the reported figures in the text are after missing data was imputed, which is why they are slightly different. GHQ = general health questionnaire. OLBI = Oldenburg burnout inventory. OLBI: D = Oldenburg burnout inventory: disengagement. OLBI: E = Oldenburg burnout inventory: exhaustion. SD = standard deviation.

Table 2.

Regression outputs for burnout, wellbeing, and patient safety outcome variables (aims 1 and 3)

	Model F statistic	Model P-value	Model R² (mean)	Job role	Practice list size	Antisocial hours	Admin hours	Extra roles	On call	Patients per day	Patient contact hours	Supportive practice
Safe practitioner	1.90	0.035	0.101	−0.047	−0.100	−0.149	0.323^a	0.095	−0.010	0.028	−0.005	−0.003
PSI	1.14	0.318	n/a	1.131	1.000	0.987	0.973	0.961	0.987^b	0.996	1.01	1.039
Adverse event^d	0.61	0.837	n/a	1.154	1.000	0.953	0.990	0.990	0.997	0.998	0.996	1.048
Near miss^d	1.36	0.179	n/a	1.060	1.000	0.984	0.976	0.959	0.983^c	1.015	1.008	1.072
OLBI	7.90	<0.001	0.313	−0.113	0.077	−0.000	0.205^c	0.092	−0.100	0.132^b	0.027	−0.413^a
OLBI: D	6.60	<0.001	0.275	−0.126	0.028	−0.069	0.165^b	0.066	−0.105	0.154^b	0.046	−0.396^a
OLBI: E	5.77	<0.001	0.249	−0.078	0.106	0.063	0.200^c	0.097	−0.075	0.085	0.004	−0.346^a
GHQ-12	5.87	<0.001	0.252	−0.129	0.026	−0.049	0.233^c	0.077	0.067	0.026	0.120	−0.301^a
QoL	9.20	<0.001	0.345	−0.001	0.026	0.026	−0.227^c	−0.210^a	0.033	−0.137^b	−0.237^a	0.339^a

Variables listed vertically indicate model outcome variables. Variables listed horizontally indicate predictor variables. Bold font indicates significant models and variables.
↵a Variable made a significant independent contribution to the model at P<0.001.
↵b Variable made a significant independent contribution to the model at P < 0.05.
↵c Variable made a significant independent contribution to the model at P < 0.01.
↵d Logistic regression. GHQ = general health questionnaire. n/a = not applicable. OLBI = Oldenburg burnout inventory. OLBI: D = Oldenburg burnout inventory: disengagement. OLBI: E = Oldenburg burnout inventory: exhaustion. PSI = patient safety incident. QoL = quality of life. All regressions controlled for age, sex, and years in practice. Statistics represent mean standardised β coefficients for linear regressions, odds ratios for logistic regressions.

Table 3.

Regression outputs indicating whether burnout and wellbeing variables explain safety outcomes (aim 2)

	Model F statistic	Model P-value	Model R² (mean)	OLBI	OLBI: D	OLBI: E	GHQ-12	QoL
Safe practitioner^a	3.58	0.002	0.091	0.267^c	–	–	0.019	−0.014
Safe practitioner^b	5.02	<0.001	0.105	–	0.015	0.300^d	–	–
PSI^e	1.33	0.242	n/a	1.012	–	–	0.881	1.078
Adverse event^e	0.79	0.576	n/a	0.980	–	–	0.940	1.063
Near miss^e	1.44	0.196	n/a	1.021	–	–	0.856^f	1.070

Variables listed vertically indicate model outcome variables. Variables listed horizontally indicate predictor variables. Bold font indicates significant models and variables.
↵a Model included only total OLBI score and not scores from the two separate scales.
↵b Model included disengagement scores and exhaustion scores, but not total OLBI score.
↵c Variable made a significant independent contribution to the model at P < 0.01.
↵d Variable made a significant independent contribution to the model at P < 0.001.
↵e Logistic regression.
↵f Variable made a significant independent contribution to the model at P < 0.05. All regressions controlled for age, sex, and years in practice. Statistics represent mean standardised β coefficients for linear regressions, odds ratios for logistic regressions. GHQ = general health questionnaire. n/a = not applicable. OLBI = Oldenburg burnout inventory. OLBI: D = Oldenburg burnout inventory: disengagement. OLBI: E= Oldenburg burnout inventory: exhaustion. PSI = patient safety incident. QoL = quality of life.