The study explores administrative burden as an antecedent of job burnout and the mediating role of perceived formalism in the interlink.
A cross-sectional survey of 1,096 primary healthcare providers (PHCPs) was conducted in Shandong Province, China. Administrative burden was measured using a four-item self-developed scale, and perceived formalism was assessed with a self-developed single item adapted to the Chinese primary healthcare context, and job burnout was measured using the Chinese version of MBI-HSS. Structural equation modeling was employed to test the hypothesized mediation effects.
Structural equation modeling showed that administrative burden had a significant direct effect on job burnout (0.141, p < 0.001). The indirect effect via perceived formalism was also significant (0.089, 95% CI [0.04, 0.11]) and accounted for 38.7% of the total effect (0.230). In addition, inspections and evaluations were the most salient component of administrative burden, with 62.7% of PHCPs reporting “much” or “very much”.
Drawing on the job demands–resources model and self-determination theory, this study identifies administrative burden as an institutional determinant of job burnout and clarifies its psychological mechanism through perceived formalism. It also offers policy insights, suggesting that better regulatory oversight, information systems, job design, and the division of labor can reduce unnecessary administrative burden and alleviate job burnout among PHCPs.
