Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderation Effect of Workload Based on the Panel Data in China

Abstract

Background: Antimicrobial resistance (AMR) causes serious increase in morbidity, mortality and costs, especially carbapenem-resistant Pseudomonas aeruginosa (CRPA). Medical professionals play an important role in tackling AMR. Available studies overlooked the impact of workload on medical professionals in the relationship between medical professionals and AMR. This study explored the relationship between medical professionals and CRPA rate and the moderation effect of medical professionals’ workload in this relationship from a macro perspective. Methods: Based on panel data in China, hierarchical regression analysis was used to explore moderation effect of workload on medical professionals and CRPA rate. Fixed-effect model was applied to estimate the moderation effect models. Medical professionals were measured by the numbers of physicians, registered nurses, pharmacists, clinical microbiologists per 1000 populations. Workload was measured by the number of daily visits of physicians. Results: The numbers of physicians, registered nurses, pharmacists and clinical technicians were significant negative with CRPA rate (Coef. = -0.889, -0.775,-1.176, -0.822; P= 0.003, 0.003, 0.011, 0.007, respectively). Workload had significant positive moderation effect between physicians, registered nurses, pharmacists, clinical technicians and CRPA rate (Coef.= 1.270, 1.400, 2.210, 1.634; P=0.004, 0.001, 0.035, 0.003, respectively). Conclusions: Increasing medical professionals may help curb CRPA. Measures to reduce medical professionals’ workload should be implemented to improve CRPA performance further.