Managed care, professional autonomy, and income

Stoddard, Jeffrey J.; Hargraves, J. Lee; Reed, Marie; Vratil, Alison

doi:10.1111/j.1525-1497.2001.01206.x

Cited by 149 publications

(65 citation statements)

References 28 publications

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“…On the one hand, provider satisfaction with autonomy has been shown to decrease with higher penetration of managed care in a given location (Baker and Cantor 1993;Collins et al 1997;Hadley and Mitchell 2002;Murray et al 2001;Warren et al 1999), perhaps as a result of providers becoming more accountable to external controls (Mechanic 2003;Warren et al 1999). Similarly, physicians in states with higher HMO penetration are less likely to say they have freedom in caring for patients (Burdi and Baker 1997;Hadley et al 1999;Stoddard et al 2001), and inpatient mental health professionals are more likely to report a lack of authority and responsibility than are those in community-based settings (Marriott et al 1994;Reid et al 1999). …”

Section: Autonomymentioning

confidence: 93%

“…Income is a major predictor of work satisfaction (Cashman et al 1990;Martin and Schinke 1998;Murray et al 2001;Pathman et al 2002;Schulz et al 1997;Stoddard et al 2001). This dimension is usually defined as ''satisfaction with total compensation: direct pay, financial or nonfinancial fringe benefits, and future prospects for financial security'' (Konrad et al 1999(Konrad et al , p. 1176.…”

Section: Satisfaction With Compensationmentioning

confidence: 96%

“…In contrast, severity of illness has continued to be a problem affecting all dimensions of provider satisfaction, especially with regard to inpatient ''revolving door'' situations (e.g., Farley 1994;Reid et al 1999). (Burdi and Baker 1997;Hadley et al 1999;Hadley and Mitchell 2002;Murray et al 2001;Stoddard et al 2001;Warren et al 1998Warren et al , 1999 Practice Model (Bates et al 1998;Chehab et al 2001;Deckard 1995;Grembowski et al 2003;Grumbach et al 1998;Keating et al 2004;Stamps 1995;Williams et al 2001) Reimbursement Method (Bates et al 1998;Keating et al 2004;Landon et al 2002Landon et al , 2003Morris and Bloom. 2002;Schulz et al 1997;Williams et al 1999b Degree MC Affiliation & MC Penetration ...…”

Section: Administrative Burdenmentioning

confidence: 97%

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Managed Care and Provider Satisfaction in Mental Health Settings

Isett

Ellis

Topping

et al. 2008

Community Ment Health J

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We assess the satisfaction of mental health providers using four dimensions from the medical practice literature--degree of autonomy, relationship with patients, compensation, and administrative burden--and extend current work on professional satisfaction to include frontline service providers rather than only psychiatrists or other physicians. In contrast to results reported for primary care settings, we find that the impact of managed care on satisfaction is minimal for the mental health providers in our study of a Medicaid capitation demonstration in the southeastern US. Instead, variables relevant to everyday working conditions have an important effect on job satisfaction.

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Section: Autonomymentioning

confidence: 93%

Section: Satisfaction With Compensationmentioning

confidence: 96%

Section: Administrative Burdenmentioning

confidence: 97%

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Managed Care and Provider Satisfaction in Mental Health Settings

Isett

Ellis

Topping

et al. 2008

Community Ment Health J

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“…Degree of autonomy found to be significantly related to career satisfaction is similar to the findings of Stoddard et al and the study by Society of General Internal Medicine (SGIM), the latter study reported that primary care physicians and specialist who rated their autonomy lower were more likely to report decreased satisfaction with their careers over a four year period. 12,13 Two studies done in developing countries one in Saudi Arabia among primary health care physicians showed 64.2% of doctors to be satisfied with autonomy and another in Karachi, Pakistan showed 54% of doctors to be satisfied with autonomy. 14,15 With regards rate of promotion 33.3% were neutral, 22.1% dissatisfied and 16.7% very dissatisfied.…”

Section: Discussionmentioning

confidence: 99%

Job satisfaction among doctors and nurses: a case study of federal medical centre Yola, Nigeria

Martins

Dahiru

Danburam

et al. 2016

Int J Community Med Public Health

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INTRODUCTIONJob satisfaction refers to how well a job provides fulfillment of a need or want or how well it serves as a source or means of enjoyment.1 In recent times the African continent has faced serious human resource shortages, which has resulted in the inability of many countries to initiate and sustain credible health services. 2Nigeria has too few doctors and nurses along poor health indicators when compared to other countries. It is a country which produces more trained health personnel than its health system uses effectively. This trained health care staffs are known to continuously migrate out of the country to more developed countries.Nigeria has been estimated to have 39,210 registered doctors, but one wonders how many of these doctors are still practicing in the country. The quality of performance of any health institution largely depends on an available human resource mix. 4 This is in regards to if the health care providers are job satisfied or not. ABSTRACTBackground: The quality of performance in the health sector to a large extent depends on whether health care providers are job satisfied or dissatisfied. The prevalence of dissatisfaction among doctors and nurses has not been given considerable attention in Nigeria though it affects patient satisfaction and is associated with reduced quality of care. This study assessed the level and factors determining job satisfaction among doctors and nurses in a federal tertiary institution. Methods: A descriptive cross sectional study was conducted involving 58 doctors and 182 nurses. Data was collected using a self-administered structured questionnaire designed with a 5 point Lickert scale that determined various levels and factors of job satisfaction that relate to 4 domains: the hospital management, hospital facilities, health care providers and pay and benefits. Scores were added to give an aggregate score for each domain and overall. Independent t-test was used to test for statistical significance in satisfaction levels between doctors and nurses. A p-value of ≤ 0.05 was considered statistically significant. Results: Overall 57.5% of respondents were satisfied or very satisfied, 18.9% neutral and 23.5% dissatisfied or very dissatisfied with all work domains. Doctors were significantly more satisfied than nurse with the hospital facilities; t=2.007, p= 0.046, while nurses were significantly more satisfied with their pay and benefits; t=-3.20, p =0.002. Conclusion: Most respondent in this study were satisfied with their jobs with minority satisfied with their remuneration. There is therefore a need to address the issue of improved remuneration for doctors and nurses.

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“…This new system was planned based on the concept of diagnosis-related groups (DRG)/PPS in the USA [1]. The DRG/PPS is a per-case payment system, and displays effects of shortening length of hospital stay (LOS), reducing total medical costs, and standardizing medical care [2][3][4]. The DPC in Japan was planned to manage the total medical costs, and adopted as a per-day payment system but not as a per-case payment system [1,4].…”

Section: Introductionmentioning

confidence: 99%

Inpatient satisfaction and job satisfaction/stress of medical workers in a hospital with the 7:1 nursing care system (in which 1 nurse cares for 7 patients at a time)

Fujimura

Tanii

Saijoh

2010

Environ Health Prev Med

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Objectives Inpatient satisfaction, job satisfaction/stress of medical workers, and hospital profitability under the 7:1 nursing care system (in which 1 nurse cares for 7 patients at a time) were compared with those under the 10:1 system at a hospital with the diagnosis procedure combination (DPC) payment system. Methods A total of 202 inpatients discharged from the Departments of Cardiology and Metabolism completed an inpatient satisfaction questionnaire.

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Managed care, professional autonomy, and income

Abstract: Our results suggest that when managed care (or other influences) erode professional autonomy, the result is a highly negative impact on physician career satisfaction.

Cited by 149 publications

References 28 publications

Managed Care and Provider Satisfaction in Mental Health Settings

Managed Care and Provider Satisfaction in Mental Health Settings

Job satisfaction among doctors and nurses: a case study of federal medical centre Yola, Nigeria

Inpatient satisfaction and job satisfaction/stress of medical workers in a hospital with the 7:1 nursing care system (in which 1 nurse cares for 7 patients at a time)

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