Background/Objectives: Burnout among healthcare professionals has become a major challenge affecting workforce sustainability, quality of care, and organizational performance. Although traditionally conceptualized as an individual response to chronic occupational stress, increasing evidence suggests that burnout is strongly influenced by broader organizational and systemic factors. This article aims to develop a multilevel conceptual framework that explains burnout as a systemic phenomenon emerging from interactions across healthcare structures, institutions, organizations, and individuals. Methods: An integrative conceptual synthesis was conducted using literature from healthcare burnout, occupational stress, organizational resilience, workforce sustainability, and health systems research. Relevant theoretical perspectives, including the Maslach Burnout Framework, Job Demands–Resources Model, Conservation of Resources Theory, and organizational resilience literature, were critically examined and integrated to develop a theory-building framework. Results: The proposed framework conceptualizes burnout as a dynamic process of pressure transfer operating across five interconnected levels: societal, political, institutional, organizational, and individual. Three central processes are identified: pressure transfer, normalization of exhaustion, and human capital erosion. The model further introduces the concepts of post-pandemic chronicization, invisible burnout, and human infrastructure to explain how prolonged systemic pressures contribute to the normalization and persistence of burnout within healthcare systems. Conclusions: Burnout should be understood not only as an individual psychological outcome but also as an indicator of systemic dysfunction. The proposed framework expands existing burnout models by integrating organizational and institutional determinants and provides a foundation for future empirical validation, workforce monitoring, and system-level interventions aimed at strengthening healthcare resilience and sustainability.

Background/Objectives: Burnout among healthcare professionals has emerged as a major occupational and organizational challenge with important implications for workforce sustainability, patient safety, and healthcare system performance. Although the scientific literature on burnout has expanded substantially, an integrated understanding of its global development, research structure, and scientific impact remains limited. This study aimed to examine the evolution, thematic development, and citation dynamics of burnout research among healthcare professionals through an integrated bibliometric approach combining science mapping, multilevel citation modelling, and critical literature synthesis. Methods: A bibliometric analysis was conducted using publications indexed in the Web of Science Core Collection between 1987 and 2024. Science mapping techniques were applied using Bibliometrix and VOSviewer to evaluate publication trends, collaboration networks, thematic development, and citation patterns. In addition, a multilevel negative binomial regression model was used to identify publication characteristics associated with citation impact. Results: A total of 1232 publications were included in the analysis. Scientific production increased markedly after 2020, temporally coinciding with the COVID-19 pandemic and growing scientific interest in healthcare workforce wellbeing. Research output was concentrated in high-income countries, particularly the United States, China, the United Kingdom, Canada, and Australia. Physicians and nurses dominated the literature, while non-clinical healthcare workers remained underrepresented. The thematic analysis indicated an increasing emphasis on organizational and system-level determinants of burnout alongside the continued presence of individual-centered perspectives. The multilevel negative binomial model identified longer title length and a greater number of author-provided keywords as being associated with lower expected citation counts, whereas a greater number of Keywords Plus terms was associated with higher expected citation counts. Conclusions: Burnout research has evolved into a rapidly expanding and increasingly interdisciplinary field. However, important gaps persist regarding geographic representation, workforce diversity, methodological standardization, and organizational intervention research. Future studies should move beyond descriptive approaches and further evaluate organizational interventions and workforce-related strategies to strengthen the evidence base that may inform healthcare policy and organizational practice.