Occupational Burnout and Associated Factors among Public Hospital Staff across Four Regions of China: A Cross-Sectional Study

Abstract

: Occupational burnout is a major workforce concern in healthcare, yet multi-city evidence spanning clinical and non-clinical hospital staff in China remains limited. This cross-sectional online survey was conducted from May to June 2025 among staff from selected public hospitals in 11 cities assigned to four study-defined regions of China. Participants included clinical medical, nursing, allied health/medical technology, and functional/administrative staff. Burnout was assessed with a 15-item Chinese occupational burnout scale covering emotional exhaustion, depersonalization, and reduced personal accomplishment. Among 592 returned questionnaires, 578 met the validity criteria. Overall, 392 participants (67.9%) met the study-defined criterion for burnout, including 268 (46.4%) with one positive dimension, 97 (16.8%) with two positive dimensions, and 27 (4.7%) with all three positive dimensions. In multivariable logistic regression, fair sleep quality (OR=2.400, 95% CI 1.205-4.783) and poor sleep quality (OR=3.126, 95% CI 1.163-8.402) were associated with higher odds of burnout compared with very good sleep quality. Poor/very poor self-reported health status was also associated with burnout (OR=10.410, 95% CI 2.516-43.074). Working 51-60 hours per week (OR=2.547, 95% CI 1.276-5.085) or at least 61 hours per week (OR=2.721, 95% CI 1.187-6.237) was associated with higher odds of burnout compared with working 40 hours or less. These findings highlight workload, sleep, and perceived health as