Mean adherence levels and 95% confidence intervals for each recommendation, after adjusting for age, sex, education, household income, alcohol consumption (except for e), and smoking status (except for f) during 1998–2012.

<p>Each point ranges from 0 (non-adherence) to 1 (perfect adherence); dark grey bars are for patients with hypertension diagnoses (HD) and light grey bars are for those without diagnoses (UD). Multivariable general linear models were used to test differences in levels of adherence to each recommendation between the HD and UD patients for all survey years. * Adjusted means are significantly different at <i>p</i> < 0.05.</p

Trends in mean systolic and diastolic blood pressures and 95% confidence intervals for patients with and without hypertension diagnoses from 1998 to 2012.

<p>Estimates were adjusted for age, sex, and use of antihypertensive agents. Solid lines are for patients with hypertension diagnoses (HD), and dotted lines are for those without diagnoses (UD).</p

Changes in overall mean adherence levels between patients with and without hypertension diagnoses from 1998 to 2012.

<p>Estimates were adjusted for age, sex, education, and household income. * Adjusted means are significantly different at <i>p</i> < 0.05; ** adjusted means are significantly different at <i>p</i> < 0.01; *** Adjusted means are significantly different at <i>p</i> < 0.001.</p

Trends in diagnosed hypertension (weighted proportion) among persons aged 30 years or older with self-reported hypertension or blood pressure ≥ 140/90 mmHg: KNHANES 1998–2012.

<p>Trends in diagnosed hypertension (weighted proportion) among persons aged 30 years or older with self-reported hypertension or blood pressure ≥ 140/90 mmHg: KNHANES 1998–2012.</p

Characteristics of adults aged ≥30 years with hypertension by survey year (N = 13,768).

<p>Characteristics of adults aged ≥30 years with hypertension by survey year (N = 13,768).</p

Association of Burnout with Workforce-Reducing Factors among EMS Professionals

<p><b>Objectives</b>: Emergency medical services (EMS) professionals often work long hours at multiple jobs and endure frequent exposure to traumatic events. The stressors inherent to the prehospital setting may increase the likelihood of experiencing burnout and lead providers to exit the profession, representing a serious workforce and public health concern. Our objectives were to estimate the prevalence of burnout, identify characteristics associated with experiencing burnout, and quantify its relationship with factors that negatively impact EMS workforce stability, namely sickness absence and turnover intentions. <b>Methods</b>: A random sample of 10,620 emergency medical technicians (EMTs) and 10,540 paramedics was selected from the National EMS Certification database to receive an electronic questionnaire between October, 2015 and November, 2015. Using the validated Copenhagen Burnout Inventory (CBI), we assessed burnout across three dimensions: personal, work-related, and patient-related. We used multivariable logistic regression modeling to identify burnout predictors and quantify the association between burnout and our workforce-related outcomes: reporting ten or more days of work absence due to personal illness in the past 12 months, and intending to leave an EMS job or the profession within the next 12 months. <b>Results</b>: Burnout was more prevalent among paramedics than EMTs (personal: 38.3% vs. 24.9%, work-related: 30.1% vs. 19.1%, and patient-related: 14.4% vs. 5.5%). Variables associated with increased burnout in all dimensions included certification at the paramedic level, having between five and 15 years of EMS experience, and increased weekly call volume. After adjustment, burnout was associated with over a two-fold increase in odds of reporting ten or more days of sickness absence in the past year. Burnout was associated with greater odds of intending to leave an EMS job (personal OR:2.45, 95% CI:1.95–3.06, work-related OR:3.37, 95% CI:2.67–4.26, patient-related OR: 2.38, 95% CI:1.74–3.26) or the EMS profession (personal OR:2.70, 95% CI:1.94–3.74, work-related OR:3.43, 95% CI:2.47–4.75, patient-related OR:3.69, 95% CI:2.42–5.63). <b>Conclusions</b>: The high estimated prevalence of burnout among EMS professionals represents a significant concern for the physical and mental well-being of this critical healthcare workforce. Further, the strong association between burnout and variables that negatively impact the number of available EMS professionals signals an important workforce concern that warrants further prospective investigation.</p