Burnout in Out-of-Hospital Emergency Healthcare Professionals: Systematic Review and Meta-Analysis

Background/Objectives: Burnout is an occupational phenomenon that particularly affects healthcare professionals exposed to sustained stress. In out-of-hospital emergency care, repeated exposure to critical incidents, violence, and demanding shift patterns may increase this risk. This review aimed to estimate the prevalence of burnout dimensions and identify factors associated with burnout among prehospital emergency care professionals. Methods: A systematic review and meta-analysis was conducted following PRISMA 2020 (PROSPERO CRD420261489417). CINAHL, LILACS, PubMed, Web of Science, and Scopus were searched in July 2026. Quantitative studies that measured burnout with the Maslach Burnout Inventory (MBI) or the Copenhagen Burnout Inventory (CBI) were included. Prevalences were pooled using random-effects models, and the certainty of the evidence was rated with GRADE. Results: Thirty-one studies (9926 unique participants) were included, 12 of which contributed to the meta-analyses. The pooled prevalence was 33% (95% CI 22–45%; I2 = 97.7%) for high emotional exhaustion, 37% (95% CI 26–48%; I2 = 97.1%) for high depersonalization and 27% (95% CI 17–38%; I2 = 97.4%) for low personal accomplishment, with overlapping confidence intervals and wide prediction intervals. The most consistent associated factors were exposure to workplace violence, lack of organizational and supervisor support, and demanding shift patterns; findings for professional role, gender, age, and years of experience were mixed. The certainty of the pooled estimates was very low. Conclusions: Around one in three prehospital professionals shows high levels in each burnout dimension, although estimates vary widely between settings. Organizational strategies focused on violence prevention, supervisory support, and early detection are needed.