A Preliminary Study on the Abnormal Deaths and Work Burden of Chinese Physicians: A Mixed Method Analysis and Implications for Smart Hospital Management

Background: The population of Chinese physicians is frequently threatened by abnormal death, including death by overwork or homicide. This is not only a health problem, but also a social problem that has attracted the attention of both hospitals and the government.Objective: This study aims to analyze the characteristics of abnormal death in physicians in Chinese hospitals from 2007 to 2020 and to investigate the relationship between abnormal death and physician workload, in order to provide information for policy makers and request improvement technologies.Methods: A mixed research method was used. In order to ensure accuracy and completeness, a relatively comprehensive search was conducted using multiple heterogeneous data sources on the abnormal death of physicians in Chinese hospitals from 2007 to 2020. The collected cases were then descriptively analyzed using the work-related overwork death risk concept framework and the deductive grounded theory approach. In addition, the workload of physicians was calculated between 2007 and 2019 based on three important workload indicators.Results: Between 2007 and 2020, 207 abnormal death events of physicians on the Chinese mainland were publicly reported. Among the 207 victims, the majority (~79%) died from overwork or sudden death. The number of victims who were men was 5.5 times higher than that of women, and victims were between the ages of 31-50 years. These physicians mainly belonged to the departments of surgery, anesthesiology, internal medicine, and orthopedics. Further analysis of the direct causes of death in cases of overwork death showed that 51 physicians (31.1%) died from cardiogenic diseases. Additionally, the per capita workload of physicians in China increased drastically by about 42% from 2007 to 2019, far exceeding physician workloads in Europe, Asia, and Australia (number of inpatients per physician in 2017: 72 vs. 55, 50, 45). The analysis revealed that there was a strong correlation between the number of abnormal deaths of physicians in China and the number of inpatients per physician (r = 0.683, P = 0.01).Conclusion: High-intensity working conditions may be positively correlated with the number of abnormal deaths among physicians. Smart hospital technologies have the potential to alleviate this situation.