Healthcare Worker Unemployment, Clinician Burnout Rose During Pandemic

Healthcare workers saw a relatively small increase in unemployment rates during the COVID-19 pandemic but experienced more clinician burnout, according to two studies published in JAMA and JAMA Network Open.

For the first study, researchers used data from the Integrated Public Use Microdata Series Current Population Survey to assess changes in unemployment among healthcare workers from January 2015 to April 2022. The survey is administered monthly to around 65,000 households nationwide to collect labor force metrics.

Researchers compared unemployment changes between January 2015 and March 2020 (pre-pandemic) to changes from April 2020 to April 2022 (pandemic). Healthcare workers were defined as any individual working in a hospital or health services.

The data reflected responses from 507,985 healthcare workers, most of whom were female, non-Hispanic White, and had bachelor’s degrees.

In the pre-pandemic period, 2.28 percent of healthcare workers and 3.82 percent of non-healthcare workers reported being unemployed. During the pandemic, the unemployment rate rose to 3.18 percent for healthcare workers and 6.13 percent for non-healthcare workers, signifying a smaller increase in reported unemployment for healthcare workers.

The study also found that the increase in the unemployment rate was smaller for hospital-based healthcare workers compared to non-hospital-based healthcare workers.

Lower-income healthcare workers, including therapists, technicians, and aides, saw a larger increase in reported unemployment during the pandemic compared to physicians.

The unemployment differences across healthcare workers may be related to how emergency funding was distributed to healthcare organizations throughout the pandemic and which service lines were prioritized, researchers noted.

Healthcare workers overall saw minimal growth in unemployment rates during the pandemic but experienced increases in clinician burnout, the second study found.

Researchers assessed emotional exhaustion among healthcare workers through routine electronic administration of the Safety, Communication, Organizational Reliability, Physician and Employee Burnout and Engagement (SCORE) survey.

They conducted the survey in 76 hospitals across three different time periods: September 2019, September 2020, and September 2021 through January 2022. The final study sample consisted of 107,122 completed surveys.

Overall emotional exhaustion increased from 31.8 percent to 34.6 percent to 40.4 percent across the study periods.

Changes in emotional exhaustion varied among different healthcare roles. For example, among physicians, emotional exhaustion decreased between September 2019 and September 2020, going from 31.8 percent to 28.3 percent, but increased to 37.8 percent in the second year.

The decline between 2019 and 2020 signified a stark difference from other healthcare workers. This may be attributed to the flexibilities physicians experienced in 2020 from an increase in telehealth utilization and decreases in patient volumes, researchers said. The sharp incline in 2021 coincides with an increase in patient volumes.

In contrast, nurses reported an increase in emotional exhaustion during the first year, from 40.6 percent to 46.5 percent, and another increase in the second year to 49.2 percent.

According to the study, nurses reported higher patient volumes, significant burdens from childcare, remote learning, and evolving processes and standards in 2020, which may have contributed to increased emotional exhaustion.

Emotional exhaustion for other roles, excluding physicians and nurses, increased from 31.2 percent to 36.3 percent to 40.5 percent across the three timeframes.

The study findings suggest a need for both institutional and individual resources for staff wellbeing to prevent healthcare worker burnout.

In May 2022, the US Surgeon General stressed the importance of addressing healthcare worker burnout and recommended that employers improve access to mental healthcare services and work to reduce administrative burden.

Burnout and stressful environments have fueled high turnover rates and exacerbated staffing shortages, especially in the nursing industry.

In addition, data from Mayo Clinic Proceedings found that primary care physician turnover, triggered partly by clinician burnout, generated over $900 million in excess healthcare spending.