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Why Is Bigger Not Always Better in Primary Health Care Practices? The Role of Mediating Organizational Factors.

ABSTRACT: Size of primary health care (PHC) practices is often used as a proxy for various organizational characteristics related to provision of care. The objective of this article is to identify some of these organizational characteristics and to determine the extent to which they mediate the relationship between size of PHC practice and patients' experience of care, preventive services, and unmet needs. In 2010, we conducted population and organization surveys in 2 regions of the province of Quebec. We carried out multilevel linear and logistic regression analyses, adjusting for respondents' individual characteristics. Size of PHC practice was associated with organizational characteristics and resources, patients' experience of care, unmet needs, and preventive services. Overall, the larger the size of a practice, the higher the accessibility, but the lower the continuity. However, these associations faded away when organizational variables were introduced in the analysis model. This result supports the hypothesized mediating effect of organizational characteristics on relationships between practice size and patients' experience of care, preventive services, and unmet needs. Our results indicate that size does not add much information to organizational characteristics. Using size as a proxy for organizational characteristics can even be misleading because its relationships with different outcomes are highly variable.

SUBMITTER: Pineault R

PROVIDER: S-EPMC5798712 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Why Is Bigger Not Always Better in Primary Health Care Practices? The Role of Mediating Organizational Factors.

Pineault Raynald R Provost Sylvie S Borgès Da Silva Roxane R Breton Mylaine M Levesque Jean-Frédéric JF

Inquiry : a journal of medical care organization, provision and financing 20160131

Size of primary health care (PHC) practices is often used as a proxy for various organizational characteristics related to provision of care. The objective of this article is to identify some of these organizational characteristics and to determine the extent to which they mediate the relationship between size of PHC practice and patients' experience of care, preventive services, and unmet needs. In 2010, we conducted population and organization surveys in 2 regions of the province of Quebec. We ...[more]

PMID: 26831624

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Project description:Background: Employees are increasingly being recognised as a valuable source of information, especially in knowledge-based businesses. Businesses, however, suffer financial and organisational memory losses related to re-hiring and training new staff, and lost productivity and intellectual property because of employee turnover. Hence, employee turnover should be considered an essential part of human resource management. Furthermore, employees' trust in management and human resource (HR) practices substantially impact organisational commitment (OC). Thus, anticipating employee commitment and turnover intentions is crucial, as people are the sole source for knowledge-based firms to maintain their competitive advantage. In the context of selected Tehran Renewable Energy (RE) firms, this study investigated the mediating impact of OC on the relationship between HR practices (recruitment and selection; training and development opportunities; performance appraisal and evaluation; teamwork; compensation and pay; and job security) and employee turnover intention. Methods: This is a cross-sectional study in Tehran that involved 90 experts and knowledgeable employees from four of Tehran's top RE businesses. A questionnaire was distributed to collect data which was later analysed with correlation, regression and bootstrapping analyses. Results: All six dimensions of HR practices were discovered to have an indirect impact on turnover intention and a direct impact on OC. OC among employees has an indirect effect on turnover intention. It was also revealed that the training and development opportunity has the most considerable effect on OC and turnover intention. OC was not found as a mediator between HR practices and turnover intention. Conclusions: The outcomes of this study showed that both training and development opportunities; and pay and compensation structure were found to be two significant components of HR practices in the relationship with OC. RE managers should employ appropriate HR strategies, particularly in these two dimensions, to improve an individual's degree of OC and reduce turnover intention.

Dataset Information

Why Is Bigger Not Always Better in Primary Health Care Practices? The Role of Mediating Organizational Factors.

Publications

Why Is Bigger Not Always Better in Primary Health Care Practices? The Role of Mediating Organizational Factors.

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