The impact of doctor burnout on quality of care is poorly understood, with many studies relying on observational findings, US researchers say.

The team from Stanford University School of Medicine in California sought to understand the true effects of burnout on quality of care by assessing the research literature, and adjusting for publication bias, selective outcome reporting and selective analysis reporting.

The review included 123 publications that looked at physicians, nurses, and other providers caring for inpatients, outpatients, adults, children, medical patients, and surgical patients.

Only four studies explicitly specified a primary outcome and 50 distinct quality metrics were used to assess the impact of overall burnout, emotional exhaustion, and depersonalisation.