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Working conditions and effort–reward imbalance of German physicians in Sweden respective Germany: a comparative study

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Abstract

Objective

Work stress among physicians is a growing concern in various countries and has led to migration. We compared the working conditions and the work stress between a migrated population of German physicians in Sweden and a population of physicians based in Germany. Additionally, specific risk factors for work stress were examined country wise.

Method

Using a cross-sectional design, 85 German physicians employed in Sweden were surveyed on working conditions and effort–reward imbalance and compared with corresponding data on 561 physicians working in Germany. Multiple linear regression analyses were applied on both populations separately to model the associations between working conditions and effort–reward ratio (ERR), adjusted for a priori confounders.

Results

German physicians in Sweden had a significantly lower ERR than physicians in Germany: mean (M) = 0.47, standard deviation (SD) = 0.24 vs. M = 0.80, SD = 0.35. Physicians in Sweden worked on average 8 h less per week and reported higher work support and responsibility. Multivariate analyses showed in both populations a negative association between work support and the ERR (β = −0.148, 95 % CI −0.215 to (−0.081) for physicians in Sweden and β = −0.174, 95 % CI −0.240 to (−0.106) for physicians in Germany). Further significant associations with the ERR were found among physicians in Sweden for daily breaks (β = −0.002, 95 % CI −0.004 to (−0.001)) and among physicians in Germany for working hours per week (β = 0.006, 95 % CI 0.002–0.009).

Conclusion

Our findings show substantial differences in work stress and working conditions in favor of migrated German physicians in Sweden. To confirm our results and to explain demonstrated differences in physicians’ work stress, longitudinal studies are recommended.

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Acknowledgments

The study coordinators would like to thank all study participants and cooperating HR managers at the different Swedish county councils. The study on the physicians in Germany was partly funded by the German Medical Association, the German Academic Exchange Service and Marburger Bund. The study on migrated German physicians in Sweden received no funding.

Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig Maximilians University Munich, Ziemssenstr. 1, 80336, Munich, Germany

    Johan Ohlander, Matthias Weigl, Raluca Petru & Katja Radon

  2. Faculty of Medicine, Institute of Occupational and Social Medicine, University of Düsseldorf, Düsseldorf, Germany

    Peter Angerer

Authors
  1. Johan Ohlander
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  2. Matthias Weigl
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  3. Raluca Petru
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  4. Peter Angerer
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  5. Katja Radon
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Correspondence to Johan Ohlander.

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Ohlander, J., Weigl, M., Petru, R. et al. Working conditions and effort–reward imbalance of German physicians in Sweden respective Germany: a comparative study. Int Arch Occup Environ Health 88, 511–519 (2015). https://doi.org/10.1007/s00420-014-0978-x

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  • DOI: https://doi.org/10.1007/s00420-014-0978-x

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