BURNOUT IN PRIMARY CARE TEAMS IN SÃO PAULO, BRAZIL: A MULTILEVEL ANALYSIS

Introduction and objective: Burnout has been increasingly identified among health care workers. It has serious consequences, such as absenteeism, decrease in productivity, turnover, abusive use of alcohol and other drugs, depression and suicide. A few studies addressed contextual factors associated with burnout in primary care workers. Our study aimed to investigate whether contextual factors (team-level and health care center-level) were associated with burnout among primary care teams (community health workers, physicians, nurses and nurses assistants). Method: We assessed the data from the PANDORA-SP study (Panorama of Primary Health Care Workers in São Paulo, Brazil: Depression, Organizational Justice, Violence at Work, and Burnout Assessments), a survey carried out in the city of São Paulo, Brazil. We used the Maslach Burnout Inventory to investigate burnout. We performed a multilevel analysis to evaluate the association between contextual factors and burnout. Results and conclusions: We assessed 351 primary care teams and 2,940 workers. Of these, 59.4% presented moderate/severe burnout. Physicians and community health workers presented higher rates of severe burnout. The variables associated with burnout: (1) at individual-level (age, profession, length of employment, working in deprived areas; (2) at health care center-level (population covered by family health program, number of primary care teams in the health care center, number of patients assisted, and management characteristics). Our findings have implications for primary care workers and for health care managers. Workers with burnout need to be recognized and assisted. Strategies to prevent burnout should include interventions to modify job context characteristics.