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Exploring staff experience of economic efficiency requirements in health care: A mixed method study
Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet, Stockholm, Sweden.
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (HAL)ORCID iD: 0000-0002-4771-8349
2019 (English)In: International Journal of Health Planning and Management, ISSN 0749-6753, E-ISSN 1099-1751, Vol. 34, no 4, p. 1439-1455Article in journal (Refereed) Published
Abstract [en]

Background: Economic resources are limited in health care, and governance strategies are used to push provider organizations to use resources efficiently. Although studies show that hybrid managers are successful in reconciling economic efficiency requirements with professional values to meet patient needs, surprisingly few studies focus on staff. The aim of this study is to explore staff members' experience of economic efficiency requirements. Methods: A mixed method design was applied, targeting multi-professional staff in the Department of Rehabilitation Medicine in a Swedish university hospital. Survey data was collected (n = 93), followed by focus-group interviews to support the understanding of the quantitative findings. Findings: The findings show that health care staff is knowledgeable and intrinsically motivated to consider efficiency requirements, albeit it should not dominate clinical decisions. However, staff experiences little influence over resource allocation and identifies limitations in the system's abilities to meet patient needs. Staff experience incorporates a local unit and a system perspective. Conclusion: Staff members are aware of economic efficiency requirements and will behave accordingly if patients are not at risk. However, their engagement seems to rely on how economic efficiency requirements are handled at multiple system levels and their trust in the system to fairly support patient needs. 

Place, publisher, year, edition, pages
2019. Vol. 34, no 4, p. 1439-1455
Keywords [en]
economic efficiency, economic governance, health care staff, hybrid professionalism, motivation
National Category
Work Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-45645DOI: 10.1002/hpm.2813ISI: 000517110400073PubMedID: 31090970Scopus ID: 2-s2.0-85065971611OAI: oai:DiVA.org:mdh-45645DiVA, id: diva2:1364943
Available from: 2019-10-23 Created: 2019-10-23 Last updated: 2020-03-19Bibliographically approved

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von Thiele Schwarz, Ulrica

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