Association between long working hours and suboptimal health status on primary care physicians：a cross-sectional survey from primary care institutions in China

Abstract Background Primary care physicians in China generally work overtime and are exposed to higher incidence of suboptimal health status (SHS). However, the quantitative relationship between long working hours and SHS on primary care physicians remains unclear. This study aims to analyze the association of long working hours and SHS in China. Methods This nationwide cross-sectional survey was conducted with a randomized stratified sampling strategy. The Sub-Health Measurement Scale V1.0 was applied to measure SHS and logit regression was further adopted to explore association between long working hours and SHS. Results A total of 1227 questionnaires from 545 primary care institutions in China returned, of which 687 were valid with 56% effective rate. All the surveyed primary care physicians reported to work over 10 hours in at least one day per week. Compared to 6–7 days/week working over 10h, the risk of global SHS in the physicians who worked over 10 hours 4–5 days/week, 2–3 days/week and 1–2 days/week were increase with OR = 2.11([95%CI [1.11 ~ 4.01],P = 0.023),OR = 2.08 (95%CI [1.13 ~ 3.81], P = 0.018),OR = 1.86 (95%CI[1.03 ~ 3.37], P = 0.039), respectively. Compared to 6–7 days/week working over 10h, the risk of social SHS in the physicians who worked over 10 hours 4–5 days/week, 2–3 days/week and 1–2 days/week were increase with OR = 2.63([95%CI [1.35 ~ 5.14], P = 0.005),OR = 1.9 (95%CI [1.04 ~ 3.49], P = 0.037),OR = 1.92 (95%CI [1.06 ~ 3.48], P = 0.031), respectively. Conclusion Different from previous studies, this study surprisingly found that higher frequency of long working hours was related to lower incidence of global SHS and social SHS among primary care physicians in China, which indicated that long working hours not a risk factor for SHS and probably since hard-working increases Chinese physicians’ self-social values further reduces the incidence of SHS.