[Influence of burnout on pharmaceutical expediture among primary care physicians]

To determine the influence of various factors related to primary care physicians and their level of burnout on pharmaceutical expenditure per policy-holder (PEP-H).

We performed a cross-sectional study of 220 primary care physicians in the province of Barcelona in 2000. A structured and validated questionnaire was administered through direct interview. The questionnaire was divided into two parts: general sociodemographic and professional data, and the Maslach Burnout Inventory (MBI). At the same time, data on primary care physicians' pharmaceutical expenditure was collected from their corresponding health districts.

The mean pharmaceutical expenditure was 264,627.22 euros (95% CI, 252,669.82-276,584.63) and the PEP-H was 152,36 euros (95% CI, 145,73-158,99). The variables associated with greater PEP-H were older age of the primary care physician, greater number of years of service in primary care, permanent work contract, primary care physicians who worked in several centers at the same time, primary care physicians who did not work in accredited teaching centers, urban centers, and high levels of emotional exhaustion in the MBI.

Primary care physicians are subject to various degrees of stress in their daily work. Accumulation of these psychological stressors provokes emotional exhaustion, which complicates decision making when writing prescriptions and tends to lead to a vicious circle. Thus, primary care physicians with a high level of burnout could, on a variety of occasions, compensate for this lack of psychological resources by less efficient management of pharmaceutical expenditure when prescribing.