Employee performance at primary healthcare centers is essential for effective service delivery, yet health workers frequently face burnout due to high patient loads and limited staffing. This study examined the effect of burnout on employee performance, with work engagement as a mediating variable, among employees of Puskesmas Buhit, Samosir Regency. Using a quantitative correlational design with total sampling, 41 employees participated. Data were collected through Likert-scale instruments measuring performance, work engagement, and burnout, and analyzed with mediation analysis (bootstrap, 5,000 resamples) in JASP. Results showed burnout had a strong negative direct effect on performance (β = -0.792, p < 0.001) and on work engagement (β = -0.235, p = 0.005). However, work engagement did not significantly affect performance (β = 0.127, p = 0.399) and did not mediate the burnout-performance relationship (indirect effect β = -0.030, p = 0.419). Burnout thus affects performance directly, without engagement functioning as a psychological bridge. These findings suggest structural, resource-based interventions are more relevant than motivational approaches in this bureaucratic healthcare context.
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