title: Associations of stress and burnout among Australian-based doctors involved in after-hours home visits.
abstract: BACKGROUND
  The after-hours house call (AHHC) service in Australia is growing, but studies have never explored the doctor variables associated with burnout and stress within the service. This study fills this knowledge gap.
  
  
  OBJECTIVE
  To determine the doctor variables associated with burnout and stress among doctors involved in AHHC.
  
  
  METHODS
  A quantitative, questionnaire-based survey of all 300 doctors engaged in AHHC through the National Home Doctor Service (NHDS), Australia's largest home visiting doctor-service provider. The Maslach Burnout Inventory (MBI) was used to assess burnout over a 12-month period from October 2013 to September 2014. Ordinal logistics regression was used to identify significant associations.
  
  
  RESULTS
  There were 168 valid responses received, giving a 56 per cent response rate. The most significant factor associated with reduced stress and burnout is the adoption of self-protection measures while on the job. Such measures include the use of chaperones, the use of panic alarms or buttons, adopting de-escalation techniques, and reliance on relevant surgery policies. Other associations with reduced stress include the attainment of postgraduate fellowships (vocational registration), working less than 24 hours per week, being in legally recognised partnerships, and being male. Conversely, having general practice as a career, being under 40 years of age, and obtaining primary medical degrees from Australia (as opposed to overseas) are all associated with increased burnout for doctors involved in AHHC.
  
  
  CONCLUSIONS
  A number of doctor variables have been found to significantly reduce burnout in AHHC Among these, the adoption of self-protective measures and the attainment postgraduate fellowships, where possible, should be encouraged among practitioners involved in the service.
authors.affiliation: School of Medicine, Griffith University, Gold Coast Campus, QLD, Australia.
authors.forename: Chris
authors.initials: C
authors.lastname: Ifediora
keywords: General practitioners; after-hours; burnout; deputising services; family physicians; stress