{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T01:26:45Z","timestamp":1777512405568,"version":"3.51.4"},"reference-count":46,"publisher":"BMJ","issue":"12","funder":[{"name":"The Danish National Research Foundation for Primary Care"},{"name":"The Danish Health Foundation"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Qual Saf"],"accepted":{"date-parts":[[2019,8,10]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Physicians\u2019 work conditions and mental well-being may affect healthcare quality and efficacy. Yet the effects on objective measures of healthcare performance remain understudied. This study examined mental well-being, job satisfaction and self-rated workability in general practitioners (GPs) in relation to hospitalisations for ambulatory care sensitive conditions (ACSC-Hs), a register-based quality indicator affected by referral threshold and prevention efforts in primary care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is an observational study combining data from national registers and a nationwide questionnaire survey among Danish GPs. To ensure precise linkage of each patient with a specific GP, partnership practices were not included. Study cases were 461 376 adult patients listed with 392 GPs. Associations between hospitalisations in the 6-month study period and selected well-being indicators were estimated at the individual patient level and adjusted for GP gender and seniority, list size, and patient factors (comorbidity, sociodemographic characteristics).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The median number of ACSC-Hs per 1000 listed patients was 10.2 (interquartile interval: 7.0\u201313.7). All well-being indicators were inversely associated with ACSC-Hs, except for perceived stress (not associated). The adjusted incidence rate ratio was 1.26 (95% CI 1.13 to 1.42) for patients listed with GPs in the least favourable category of self-rated workability, and 1.19 (95% CI 1.05 to 1.35), 1.15 (95% CI 1.04 to 1.27) and 1.14 (95% CI 1.03 to 1.27) for patients listed with GPs in the least favourable categories of burn-out, job satisfaction and general well-being (the most favourable categories used as reference). Hospitalisations for conditions not classified as ambulatory care sensitive were not equally associated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>ACSC-H frequency increased with decreasing levels of GP mental well-being, job satisfaction and self-rated workability. These findings imply that GPs\u2019 work conditions and mental well-being may have important implications for individual patients and for healthcare expenditures.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjqs-2018-009039","type":"journal-article","created":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T17:19:27Z","timestamp":1566235167000},"page":"997-1006","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Mental well-being, job satisfaction and self-rated workability in general practitioners and hospitalisations for ambulatory care sensitive conditions among listed patients: a cohort study combining survey data on GPs and register data on patients"],"prefix":"10.1136","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2520-104X","authenticated-orcid":false,"given":"Karen Busk","family":"N\u00f8r\u00f8xe","sequence":"first","affiliation":[{"name":"Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anette Fischer","family":"Pedersen","sequence":"additional","affiliation":[{"name":"Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders Helles","family":"Carlsen","sequence":"additional","affiliation":[{"name":"Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flemming","family":"Bro","sequence":"additional","affiliation":[{"name":"Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Vedsted","sequence":"additional","affiliation":[{"name":"Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,8,19]]},"reference":[{"key":"2025090411342219000_28.12.997.1","doi-asserted-by":"crossref","unstructured":"N\u00f8r\u00f8xe KB , Pedersen AF , Bro F , et al . 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