Prevalence, predictors and outcomes of physician care left undone in acute care hospitals across six European countries during COVID-19: A cross-sectional study.

Objective: To examine the prevalence, antecedents and consequences of physician care left undone in acute care hospitals.

Design: A multicentre, multinational, cross-sectional survey. An 11-item scale measured physician reports of care left undone. Antecedent measures examined were work environment and perceived workload. Potential consequences examined included emotional exhaustion, job dissatisfaction and perceived quality of care. Generalized linear mixed models were estimated to quantify associations between physician care left undone and the theorized antecedents and consequences.

Setting: 56 acute care hospitals in six European countries.

Participants: 1 963 physicians providing direct patient care to adult in-patients.

Results: Four in five (78.3 %) physicians left one or more care activities undone during their last shift. On average 3.1 (SD 1.0) of 11 activities were left undone. This varied between and within countries. A 10 % increase at the hospital level of physicians saying they have too much work to do, significantly increased the odds of one or more activities being left undone (OR 1.414, 95 % CI 1.268-1.578). Physicians' reports of care left undone were associated with increased odds of emotional exhaustion (OR 3.867, 95 %CI 2.683-5.575) and rating quality of medical care as poor or fair (OR 3.395, 95 % CI 2.215-5.204).

Conclusion: Physicians frequently report leaving some necessary care undone. A shortage of resources compromises physicians' ability to do their jobs, impacting the quality of care they deliver and their job satisfaction and well-being. Ensuring adequate healthcare personnel resources should be a top priority for hospitals.