Objectives We studied the characteristics of patient and visitor violence (PVV) and the workload of doctors and nurses, and identified the correlation between the incidence of PVV and healthcare worker (HCW) workload in China. Design Cross-sectional study. Setting 288 public health institutions in a city in northern China. Participants Data on 87 998 HCWs were extracted from the 2015 database of the Medical Quality and Safety Notification System. Measures The data included characteristics of the healthcare institution, types of services provided, information about each complaint and reported PVV incidents by hospital level. Pearson correlation analysis and multiple linear regression modelling were used to identify the correlation between the incidence of PVV and HCW workload. Results Three types of institutions were identified as being at particularly high risk for PVV: tertiary hospitals, specialised hospitals and institutions in a downtown district. Incidence rates of PVV at tertiary hospitals, specialised hospitals and institutions in a downtown district were 16.6%, 17.6% and 22.8%, respectively. All three types of institutions had a high inpatient workload (admissions per doctor per day): 0.15, 0.17 and 0.12, respectively. After controlling for scale, type and location, it was found that the overall incidence rate of PVV increased with increasing outpatient workload (β=0.236, p<0.01). Conclusions PVV poses a significant challenge to public health institutions in China, and the high workload of HCWs likely contributes to higher risk of PVV. Prevention and intervention of PVV may be targeted to HCWs at specific institutions. The patient complaint notification system needs improvement and could be, for example, a better source of PVV information for future interventions.

Workplace violence against healthcare workers (HCWPV) is a global public health and occupational hazard, endangering staff physical/psychological well-bein

Psychosocial factors are recognized occupational hazards, yet psychosocial risk assessment is rarely stratified by how work is organized, and its integrati