Burnout Among Health Care Workers Drops Post Pandemic but Remains Elevated

Although burnout and professional stress levels among health care workers has decreased following the COVID-19 pandemic, burnout remains higher than prepandemic levels, according to a study published today in JAMA Network Open.1

The COVID-19 pandemic exacerbated burnout challenges among health care workers and introduced new ones, leading many to consider early retirement or changing roles. In response, organizations aimed to better support employees, ease workloads, and maintain patient care quality.

While some studies suggest burnout began to decline after increasing during the pandemic, others report it remained unchanged or even worsened.2 Because of this, questions remain about the long-term impact of pandemic-related disruptions on health care workers.1 Similarly, organizations are unsure whether the support programs introduced during the COVID-19 pandemic will become standard, expand, or phase out.

For example, the Veterans Health Administration (VHA), the largest integrated health system in the US, implemented various programs during the pandemic to reduce burnout and support staff well-being, including increasing telework and telehealth options. However, the impact of these efforts on reducing burnout has not yet been studied.

Despite recent declines, health care worker burnout has not returned to prepandemic levels and remains a persistent concern across roles and settings. | Image Credit: D Lahoud/peopleimages.com - stock.adobe.com

To address this gap, the researchers analyzed health care worker burnout and professional stress trends before, during, and after the COVID-19 public health emergency declaration using data from the VHA’s all-employee survey (AES) collected between 2018 and 2023. The study also aimed to examine burnout levels across different health care occupations and settings.

The study population was restricted to respondents across the VHA’s 140 medical centers who self-identified as health care workers. For each respondent, burnout was measured using 2 Maslach Burnout Inventory items, representing emotional exhaustion (“I feel burned out from my work”) and depersonalization (“I worry that this job is hardening me emotionally”).

With a 7-point frequency scale, respondents rated these items from “never” to “every day.” Those who reported experiencing either symptom at least once a week were considered to be experiencing burnout.

Additionally, the researchers assessed COVID-19 professional stress from 2020 to 2023 using the item, “How much stress has the COVID-19 pandemic added to your day-to-day work?” Response options included none, minimal, moderate, high, and extreme. They considered those who answered “high” or “extreme” to have high stress.

The annual response rate was 210,057 out of 341,144 eligible respondents (61.6%) in 2018 and 293,164 out of 394,646 (74.3%) in 2023. Of these respondents, 123,271 in 2018 and 169,448 in 2023 were health care workers.

Burnout remained relatively stable leading into the pandemic and during the first year (30.4% in 2018; 31.3% in 2019; 30.9% in 2020) before increasing significantly in 2021 (35.4%) and 2022 (39.8%). However, after the COVID-19 public health emergency ended in May 2023, burnout decreased to 34.4% (P < .001). Overall, year-to-year burnout changes were 3.0% from 2018 to 2019, –1.9% from 2019 to 2020, 15.6% from 2020 to 2021, 13.0% from 2021 to 2022, and –11.5% from 2022 to 2023.

Primary care physicians consistently experienced the highest burnout, ranging from 46.2% in 2018 to 57.6% in 2022. The researchers also found increases in burnout across all service areas, with the largest rises in dental (from 30.7% to 39.6%), mental health (from 30.4% to 38.2%), and rehabilitation (from 27.1% to 34.1%).

Additionally, the rate of high professional stress peaked in 2020 at 32.0%, declined in 2021 to 26.9%, slightly increased in 2022 to 29.2%, and dropped to 21.4% after the pandemic (P < .001). Year-to-year changes in stress were –15.8% from 2020 to 2021, 8.3% from 2021 to 2022, and –26.6% from 2022 to 2023.

At the pandemic's onset, employees working in the intensive care unit (ICU; 48.6%), emergency medicine (45.8%), acute care (40.0%), and community living centers (39.6%) reported the highest stress levels. By 2023, all service areas saw a decrease in professional work stress, with the largest decreases among optometry (16.3%), administrative areas (14.1%), emergency medicine (13.2%), and the ICU (12.9%).

Telehealth and telework usage among health care workers increased during the study period. The percentage of health care workers with limited telework rose from 8.4% in 2018 to 20.9% in 2023, and those with mostly telework increased from 3.4% to 11.8%. Burnout was lower among those teleworking most days, ranging from 26.2% in 2018 to 37.7% in 2022. In contrast, burnout among health care workers with no telework ranged from 30.5% to 40.0% (P < .001).

Employees who teleworked most days reported the lowest stress rates annually, while those with some telework had slightly higher stress levels, and those with no telework had the highest stress levels.

The researchers concluded by acknowledging their limitations, including their inability to connect specific practice changes to a reduction in burnout and stress. They explained that it is not always clear which activities have the most impact on improving the workplace, which makes it harder to understand which practices may be cost-effective and useful for making these improvements. Given their limitations, the researchers encouraged further research into this topic.

“As health care organizations continue in the postpandemic phase, it remains important to find ways to continue and sustain improvements in health care worker well-being and reduce burnout at work,” the authors wrote. “…we believe there is great value for health care workers and health care systems in documenting changes in burnout rates and studying the influence of proactive organizational efforts.”

References

1. Mohr DC, Elnahal S, Marks ML, Derickson R, Osatuke K. Burnout trends among US health care workers. JAMA Netw Open. 2025;8(4):e255954. doi:10.1001/jamanetworkopen.2025.5954
2. Bruyneel A, Bouckaert N, Maertens de Noordhout C, et al. Association of burnout and intention-to-leave the profession with work environment: a nationwide cross-sectional study among Belgian intensive care nurses after two years of pandemic. Int J Nurs Stud. 2023;137:104385. doi:10.1016/j.ijnurstu.2022.104385