(HealthDay News) — In the published literature, burnout in health care professionals is frequently associated with poor-quality care, but the effect size may be smaller than reported, according to data from a systematic review published online Oct. 8 in the Annals of Internal Medicine.

Daniel S. Tawfik, M.D., from the Stanford University School of Medicine in California, and colleagues estimated the relationship between burnout and quality of care and examined whether published studies provide exaggerated estimates of this correlation. Data were included from 123 publications with 142 study populations encompassing 241,553 health care providers.

The researchers observed highly heterogeneous relations between burnout and quality of care (I² = 93.4 to 98.8 percent). Fifty-eight of 114 unique burnout-quality combinations indicated burnout related to poor-quality care, six indicated burnout related to high-quality care, and 50 showed no significant effect. Excess significance was apparent, with 73 percent of studies observed versus 62 percent predicted to have statistically significant results. This indicator of potential bias was mostly seen for the least-rigorous quality measures of best practices and quality and safety.

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“Few rigorous studies exist, and the effect size may be smaller than reported — and may be particularly smaller for objective quality measures,” the authors write. “Whether curtailing burnout improves quality of care, or whether improving quality of care reduces burnout, is not yet known, and adequately powered and designed randomized trials will be indispensable in answering these questions.”

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