Opportunity loss: care team job satisfaction and urgent care, emergency department, and hospital costs for patients with cardiovascular disease

Objective This study evaluates the association between primary care team job satisfaction and urgent care, emergency department, and hospital costs for their patients with cardiovascular disease (CVD). Study design Electronic health record (EHR)-extracted observational study alongside a cross-sectional health care professional survey. Methods A total of 143 health professionals, including physicians and clinical staff, at 5 US primary care clinics participated in a cross-sectional survey about job satisfaction. Urgent care visits, emergency department visits, hospital visit days, and medical costs in the past 12 months for each care team's panel of patients were extracted from the EHR. Three-level hierarchical modelling evaluated the link between team job satisfaction, urgent care visits, emergency department visits, hospital visit days, and medical care costs in the past 12 months for the team's patients with diagnosed CVD. Results Teams with higher satisfaction with their freedom of work methods, work hours, and income were associated with fewer hospital days (odds ratio = 0.85, 0.72, and 0.81, respectively) and lower medical care costs -$474, -$650, and -$397 per patient, respectively) for their patients with CVD. Overall job satisfaction was not significantly associated with cost of care. Conclusions Health care employee job satisfaction in primary care is an important factor to consider in efforts to lower medical costs for patients with CVD. Lay Summary This article analysed the association between job satisfaction in primary care teams and urgent care, emergency department, and hospital costs for the team's patients with cardiovascular disease. Greater satisfaction with primary care team freedom of work methods, work hours, and income were associated with fewer hospital days and lower medical care costs for the team's patients with cardiovascular disease. Health care employee job satisfaction in primary care is an important factor to consider in efforts to lower medical costs for patients with cardiovascular disease.