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Do associations between employee self‐reported organizational assessments and attitudinal outcomes change over time? An analysis of four Veterans Health Administration surveys using structural equation modelling

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  • Sonali Das
  • Ming‐Hui Chen
  • Nicholas Warren
  • Michael Hodgson

Abstract

This paper evaluates relationships between healthcare employees' perceptions of three hospital organizational constructs (Leadership, Support and Resources), and their assessment of two employee‐related outcomes (employee satisfaction and retention) and two patient‐related outcomes (patient satisfaction and quality of care). Using four all‐employee surveys conducted by the Veterans Health Administration in the United States between 1997 and 2006, we examine the strength of these relationships and their changes over time. Exposure and outcome measures are employee‐assessed in all the surveys. Because it can accommodate both latent and measured variables into the model, Structural Equation Modelling (SEM) is used to capture and quantify the relationship structure. The aim of the project is to identify possible intervention foci. The analyses revealed that employee‐related outcomes are improved by increases in Leadership and Support, and, not surprisingly, the outcome variable of employee satisfaction reduced turnover intention. The employee assessed patient‐related outcomes of satisfaction and quality of care were most improved by increases in Resources. Results also indicate that the three organizational constructs and the web of associations characterized by SEM underwent changes over the study period, perhaps in relation to changes in VHA policy emphases, changes in survey wording and other possible unmeasured factors. Copyright © 2010 John Wiley & Sons, Ltd.

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  • Sonali Das & Ming‐Hui Chen & Nicholas Warren & Michael Hodgson, 2011. "Do associations between employee self‐reported organizational assessments and attitudinal outcomes change over time? An analysis of four Veterans Health Administration surveys using structural equatio," Health Economics, John Wiley & Sons, Ltd., vol. 20(12), pages 1507-1522, December.
    • Handle: RePEc:wly:hlthec:v:20:y:2011:i:12:p:1507-1522
    DOI: 10.1002/hec.1692
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    6. Brickley, James A & Van Horn, R Lawrence, 2002. "Managerial Incentives in Nonprofit Organizations: Evidence from Hospitals," Journal of Law and Economics, University of Chicago Press, vol. 45(1), pages 227-249, April.
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    1. Fredrik Ødegaard & Pontus Roos, 2013. "Measuring Worksite Health Promotion Programs: an application of Structural Equation Modeling with ordinal data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(4), pages 639-653, August.

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