Factors associated with overwork among pediatricians at Japanese hospitals

Abstract

Background Given the global health issue of doctors working excessive hours, working practices for doctors in Japan are currently undergoing reform. We aimed to ascertain the actual situation of excessive working hours among pediatricians and factors influencing these conditions in Japan. Methods Pediatricians employed at hospitals throughout Japan completed a questionnaire regarding their current working situation, including the time spent at the hospital and whether their working environment had improved since 2018, when the reform of doctors’ working practices began. Multiple logistic regression analysis was performed to identify background factors associated with excessive working hours. Results Questionnaires were sent to 848 Japanese hospitals that submitted insurance reimbursement claims for pediatric inpatient treatment. Valid responses were received from 1,539 pediatricians at 416 hospitals (49% response rate). Of these pediatricians, 51.7% spent ≥60 h/week at their hospital, 14.4% spent ≥80 h/week, and 47.4% worked nights at least four times a month. Compared with 2018, 8.8% and 35.4% responded that their working environment had greatly or somewhat improved, respectively. Working for ≤60 h/week was considered appropriate by 81.9% of pediatricians. Background factors associated with spending ≥80 h/week at the hospital were male sex, age <30 years, lack of children, specialty of pediatric cardiology, annual income exceeding ¥16 million, employment at a private university hospital, and employment at a hospital with a comparatively large number of pediatricians. Conclusions This study clarified the background factors and the actual situation of the long working hours among pediatricians working in Japanese hospitals.