Only One Burnout Estimator Is Consistently Associated with Health Care Providers’ Perceptions of Job Demand and Resource Problems

Abstract

Five “high” burnout estimators are in common use. Each is based on a different subset of the three aspects of “Burnout Syndrome”, so each gives a different estimate of the “high” burnout prevalence in a population. Managers often don’t know these prevalences are incomparable. Managers also have little specific information on how their institution’s burnout measure is associated with their employees’ perceptions of problems in job demands and resources in their work environment, as regularly queried in organizational health surveys. In the current study, we demonstrated the differences in the prevalences of “high” burnout obtained using each of five “high” burnout estimators. We also evaluated and compared the five burnout estimators’ associations with employee-perceived problems in each of 31 areas of job demands and resources in human-systems functioning. We measured these associations by how much more the aspects of burnout queried in the estimator were reported by those who perceived a problem than by those who did not (the positive likelihood ratio, LR+). We examined five types of physicians (6599), nurse practitioners (2158) and physician assistants (786). We found that four of the “high” burnout estimators showed few associations with employee perceptions of problems in job demands or resources, but one estimator—the trivariate joint occurrence of “high” (i.e. frequent) emotional exhaustion, “high” depersonalization and “low” sense of personal accomplishment (measured by well-validated single-item surrogates for the three Maslach Burnout Inventory subscales)—was clinically significantly associated with 97% (30) of the problems in job demands and resources studied, in at least one of the health provider groups. Our results challenge the current preference for “high” emotional exhaustion dominated “high” burnout estimators.